Pars Plana Vitrectomy With Gas Tamponade for Lamellar Macular Holes
ABSTRACT To report anatomic and visual improvement after pars plana vitrectomy with gas tamponade for a lamellar macular hole with poor central visual acuity.
Two interventional case reports.
Two patients with a lamellar macular hole underwent vitrectomy, internal limiting membrane peeling, and long-acting gas injection. Main outcome measures included best-corrected visual acuity, biomicroscopic appearance, and optical coherence tomography findings.
Vitrectomy with gas tamponade resulted in biomicroscopic, functional, and tomographic improvement in both patients for follow-up periods of 12 months.
Vitrectomy with gas tamponade may be an effective method for a lamellar macular hole with poor visual acuity.
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ABSTRACT: The purpose of this study was to compare anatomic and visual changes in patients with lamellar macular hole undergoing pars plana vitrectomy with those in patients undergoing follow-up only. In this retrospective consecutive case series study, we evaluated two groups of eyes, comprising 19 eyes from 19 patients with lamellar macular hole who underwent pars plana vitrectomy with internal limiting membrane peeling and 21 eyes from 21 patients with lamellar macular hole who had follow-up only. Corrected distance visual acuity (CDVA, in logMAR) and optical coherence tomography findings, including measurements of maximum diameter of lamellar defect and foveal thickness, and whether the inner segment/outer segment band was intact or not were documented at initial and follow-up examinations. At initial examination, mean CDVA was 0.54 logMAR in the study group and 0.51 logMAR in the control group, and 0.33 logMAR and 0.55 logMAR, respectively, on final examination. In the study group, postoperative optical coherence tomography images were found to be normalized in ten patients (52.6%), improved in six (31.5%), unchanged in two (10.5%), and to have progressed to full-thickness macular hole in one (5.2%) in the intervention group, while all patients in the control group were found to have deteriorated within the follow-up period between March 2004 and June 2010. In patients with lamellar macular hole, combination treatment with pars plana vitrectomy and internal limiting membrane peeling appears to be effective, but further studies are required to establish new treatment modalities for patients who do not have a satisfactory outcome from treatment.Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:1843-1848. DOI:10.2147/OPTH.S46283
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ABSTRACT: Optical coherence tomography (OCT) is now a standard of care in ophthalmology and is considered essential for the diagnosis and monitoring of many retinal diseases. One of the major advances obtained with OCT was the understanding of the pathophysiology of macular holes. Non-full-thickness macular holes have been revisited because high-resolution OCT images can detect a lamellar macular defect that is not always visible clinically, and surgery has been advocated by some authors. OCT can be valuable in determining the need for and/or timing of surgical intervention on epiretinal membranes or vitreomacular traction syndrome. In addition, we can use this technology as a predictive factor in the prognosis and follow-up of the most common posterior pole pathologies.Clinical ophthalmology (Auckland, N.Z.) 11/2013; 7:2165-2179. DOI:10.2147/OPTH.S51098
Chapter: Pelagem da limitante interna?Buraco Macular 25 perguntas e Respostas, Edited by GER - Grupo de Estudos da Retina, 01/2013: chapter Pelagem da limitante interna?;