Outcomes of Eyes with Failed Primary Surgery for Idiopathic Macular Hole

Yek, John T.O.; Essex, Rohan W.; Luckie, Alan; Hunyor, Alex P.; Chang, Andrew; Kwan, Anthony; Clark, Ben; Fleming, Ben; Fabinyi, David; Chauhan, Deepender; Roufail, Edward; Chen, Fred K.; Wong, H C; Kang, Hyong Kwon; McAllister, Ian L.; Reddie, Ian; Gilhotra, Jagjit S; Ambler, John S.; Downie, J. A.; Evans, Kay; Lee, Lawrence R.; McCombe, Mark; Branley, Michael; Saha, Niladri; Allen, PM; Hadden, Peter W.; Bourke, Robert D.; Buttery, Robert; Phillips, Russell; Chen, Simon; Lake, Stewart; Campbell, William; Heriot, Wilson

doi:10.1016/j.oret.2017.10.012

Cited by 23 publications

(21 citation statements)

References 34 publications

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“…Two of the described above patients presented bilateral FTMH, one eye was operated with anatomical success, and the second one failed to close after primary surgery, thus secondary PPV was performed. Reported secondary closure rate of revision surgeries was equal 76% [ 8 ]. Yek et al and colleagues observed 85% closure rate of FTMH after secondary vitrectomy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reported secondary closure rate of revision surgeries was equal 76% [ 8 ]. Yek et al and colleagues observed 85% closure rate of FTMH after secondary vitrectomy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Viscoat or blood was used to help fixing the retinal free flap and additionally contain multiple growth factors [ 18 ]. Yek et al achieved a high secondary closure rate of FTMH and good visual outcomes mostly performing PPV with perfluoropropane gas as tamponade, ILM peeling without any additional procedures to close the hole (e.g., inverted flap technique), and face-down positioning [ 8 ]. They reported the progressive improvement of VA after secondary vitrectomy, similar to the trend after successful primary surgery [ 8 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are some cases of persistent macular holes, defined as idiopathic macular holes that underwent vitrectomy but were never observed to close in the postoperative period. There is also the less common condition of reopened or recurrent macular hole, where the hole is observed to close after surgery but subsequently reopens [ 8 ]. The failure rate of primary surgery in FTMH is less than 10% [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Secondary Vitrectomy with Internal Limiting Membrane Plug due to Persistent Full-Thickness Macular Hole OCT-Angiography and Microperimetry Features: Case Series

Wrzesińska

Nowomiejska

Nowakowska

et al. 2020

Journal of Ophthalmology

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Purpose. To study the features in OCT-angiography and microperimetry in eyes with persistent full-thickness macular hole (FTMH) closed with the secondary plana vitrectomy (PPV) with autologous internal limiting membrane (ILM) plug. Methods. Secondary PPV was performed with closing the persistent FTMH with ILM plug, C3F8 tamponade, and face-down positioning. Four patients were followed for 6 months with best corrected visual acuity (BCVA) measurement, SD-OCT and OCT-A, and microperimetry. The results were compared with the fellow eye; in two patients, it was the healthy eye, and in two remaining eyes, successfully closed FTMH after primary PPV. Results. ILM flap was integrated in all cases with V-shape of closure, and atrophy was found in one case, with the largest diameter of FTMH. BCVA improved in two cases and remained the same in two cases. In OCT-A, the area of foveal avascular zone (FAZ) was larger, and foveal vessel density (FVDS) was smaller in eyes after secondary PPV in comparison to fellow eyes. In microperimetry, retinal sensitivity was lower in eyes after secondary PPV, and eccentric fixation was found in 2 of 4 patients. Conclusion. Although the anatomical results of repeated surgeries of FTMH with ILM plug are favorable, visual function results may be limited. Secondary closure of FTMH with ILM plug may lead to atrophy, changes in the macular vasculature, and eccentric fixation. The trial is registered with NCT03701542.

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Section: Discussionmentioning

confidence: 99%

“…Reported secondary closure rate of revision surgeries was equal 76% [ 8 ]. Yek et al and colleagues observed 85% closure rate of FTMH after secondary vitrectomy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Secondary Vitrectomy with Internal Limiting Membrane Plug due to Persistent Full-Thickness Macular Hole OCT-Angiography and Microperimetry Features: Case Series

Wrzesińska

Nowomiejska

Nowakowska

et al. 2020

Journal of Ophthalmology

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“…found that extended and more complete ILM peeling could enhance the chance of MH closure. It has been shown that extended ILM peeling in a second surgery for patients with unsuccessful previous macular hole surgery leads to success in FTMH closure and visual acuity improvement [ 22 , 23 ]. Yek et al concluded that visual acuity gain after two years was significantly higher in eyes undergoing secondary surgery with extended ILM peeling after the first surgery failure than the eyes that were followed without any secondary intervention [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Idiopathic Full-Thickness Macular Hole Surgery: Comparing Two Different ILM Peeling Sizes

Khodabande

Mahmoudi

Faghihi

et al. 2020

Journal of Ophthalmology

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Purpose. This study aimed to show the impact of different extents of internal limiting membrane (ILM) peeling on visual and anatomical outcomes following idiopathic full-thickness macular hole (FTMH) surgery. Methods. In this single-center prospective study, patients with idiopathic FTMH underwent standard pars plana vitrectomy with two different extents of ILM peeling: 2-disc diameters (DD) or 4 DD. The main outcome measures were the closure rate of the holes based on optical coherence tomography (OCT) findings at three months after surgery. Results. Forty eyes from 39 patients were enrolled in the study. After three months, anatomical closure was achieved in 78% and 76% eyes in 2 DD peel and 4 DD peel groups, respectively. From 29 eyes with macular hole index (MHI) ≤ 0.5, type 1 closure was achieved in 42% eyes receiving a 2 DD ILM peel, compared to 66% eyes receiving a 4 DD peel p=0.041. In comparison, this significant difference was not seen in the subgroup of MHI > 0.5 p=061. In the subgroup of subjects with baseline MHI ≤ 0.5, visual improvement was significantly more in eyes with 4 DD ILM peeling p=0.034, which was not seen in the MHI > 0.5 subgroup p=0.61. Conclusion. In patients with idiopathic full‐thickness macular hole (MHI ≤ 0.5), a larger ILM peel of 4 DD appears to yield better anatomical outcomes than a more limited 2 DD peel.

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Macular Hole

Williamson¹

2021

Vitreoretinal Surgery

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Outcomes of Eyes with Failed Primary Surgery for Idiopathic Macular Hole

Cited by 23 publications

References 34 publications

Secondary Vitrectomy with Internal Limiting Membrane Plug due to Persistent Full-Thickness Macular Hole OCT-Angiography and Microperimetry Features: Case Series

Secondary Vitrectomy with Internal Limiting Membrane Plug due to Persistent Full-Thickness Macular Hole OCT-Angiography and Microperimetry Features: Case Series

Outcomes of Idiopathic Full-Thickness Macular Hole Surgery: Comparing Two Different ILM Peeling Sizes

Macular Hole

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