Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery-our experience

Singh, Shalini

doi:10.4103/0301-4738.149158

Cited by 3 publications

(4 citation statements)

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“…MH revealed complete closure at the two-week follow-up after re-surgery. Singh et al [9] also performed simple uid-air exchange with 14% C 3 F 8 gas injection in 3 patients with IMH who failed the primary PPV operation and found that the holes were closed and that visual acuity improved in 6 weeks after surgery. 4 patients in the above studies had the characteristic "cuff" sign.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of simple intravitreal gas injection for treating unclosed idiopathic macular holes after vitrectomy

Dou,

Han,

Zhao

2024

Preprint

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Background This study aimed to observe the efficacy of simple intravitreal injection of C3F8 in the treatment of unclosed idiopathic macular holes (IMH) in patients after primary pars plana vitrectomy (PPV). Methods This was a retrospective clinical observational study. Patients diagnosed with unclosed IMH who underwent primary PPV combined with internal limiting membrane peeling (ILMP) and air tamponade were included in the study. Optical coherence tomography (OCT) at 1 week after PPV revealed unclosed IMH with the "cuff" sign and intraretinal cysts. The next day, the patients were treated by simple intravitreal injection of C3F8. All patients underwent best corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus photography, and OCT before PPV and at 1 week, before and after intravitreal gas injection for 1 to 3 months. Results The minimum horizontal hole diameter (MHD) before PPV was 555.4 ± 104.8 µm, and that at 1 week after PPV was 335.1 ± 74.3 um, with statistically significant (t = 11.256, P < 0.001). The percentage of closed holes after air tamponade was 100%. The mean BCVA before PPV was 0.79 ± 0.26 logMAR (20/123), and that after air tamponade was 0.48 ± 0.19 logMAR (20/30) with statistical difference significantly (t = 5.303, P = 0.002). Conclusion For patients with enclosed IMH after primary PPV, if OCT reveals the "cuff" sign, retreatment can be performed through simple intravitreal gas injection. The method is simple, economical, practical, and effective.

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Section: Discussionmentioning

confidence: 99%

Efficacy of simple intravitreal gas injection for treating unclosed idiopathic macular holes after vitrectomy

Dou,

Han,

Zhao

2024

Preprint

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“…RPE pumps then drive the fluid out of the swollen macula. [ 13 14 15 16 17 18 19 ] Comparison of other studies evaluating the treatment of persistent macular holes by FGE is given in Table 4 . The largest study till date was conducted by Rao et al .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown that “fluid-gas exchange (FGE)” can be used for the treatment of persistent macular holes. [ 13 14 15 16 17 18 19 ] However, all these studies included mostly small and Stage III macular holes. The number of patients with large macular holes in these studies was minimal.…”

mentioning

confidence: 99%

Retrospective study of changes in ocular coherence tomography characteristics after failed macular hole surgery and outcomes of fluid-gas exchange for persistent macular hole

Vishal

Babu

Kohli

et al. 2018

Indian J Ophthalmol

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Purpose:The aim is to study the changes in ocular coherence tomography (OCT) parameters of large (≥400 μ) full-thickness macular holes (FTMHs) after a failed surgery and evaluate the outcome of fluid-gas exchange (FGE) in the treatment of persistent macular hole and role of OCT in predicting outcome after the secondary intervention.Methods:Changes occurring in the OCT parameters of FTMH after a failed vitrectomy were evaluated. FGE was done in an operating room with three pars plana sclerostomy ports. The anatomical and functional outcomes of FGE for these persistent macular holes were also assessed. Anatomical closure was defined as the flattening of the hole with resolution of subretinal cuff of fluid. Anatomical success after FGE was defined as flattening of macular hole with the resolution of subretinal cuff of fluid and neurosensory retina completely covering the fovea. Functional success was defined as an improvement of at least one line of best-corrected visual acuity (BCVA).Results:Twenty-eight eyes (28 patients) were included in the study. After the failed vitrectomy, OCT showed an increase in the base diameter, opening diameter, and height of the hole. After the secondary procedure, anatomical closure was achieved in 89.3% eyes. Mean BCVA improved from logMAR 0.88 ± 0.24 (20/152) to logMAR 0.66 ± 0.24 (20/91) (P < 0.001). Eight (28.6%) patients achieved final BCVA ≥20/60. Functional success was obtained in 19 patients (67.9%). There was no association between anatomical success after FGE and any of the pre-FGE OCT parameters or indices.Conclusion:Unsuccessful surgery causes swelling of the outer and middle retinal layers with retraction of inner layers of the retina. Performing FGE while visualizing the retina is a good option for the treatment of large persistent macular holes as it causes complete drying of the macula, better success rates, and a reduced complication rate. Pre-FGE OCT does not help in predicting the outcome of FGE for persistent macular hole.

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“…We thank the authors for their interest in our article. [ 1 2 ] We welcome their inputs and opinion. We would like to reiterate that these observations apply to “idiopathic” macular holes and that case selection is important.…”

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confidence: 99%

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Rishi

Reddy

Rishi

2014

Indian J Ophthalmol

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Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery-our experience

Cited by 3 publications

References 1 publication

Efficacy of simple intravitreal gas injection for treating unclosed idiopathic macular holes after vitrectomy

Efficacy of simple intravitreal gas injection for treating unclosed idiopathic macular holes after vitrectomy

Retrospective study of changes in ocular coherence tomography characteristics after failed macular hole surgery and outcomes of fluid-gas exchange for persistent macular hole

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