Pars Plana Vitrectomy With Gas Tamponade for Lamellar Macular Holes

Department of Ophthalmology, Kagoshima City Hospital, 20-17 Kajiya-cho, Kagoshima 892-8580, Japan.
American Journal of Ophthalmology (Impact Factor: 4.02). 01/2006; 140(6):1154-1155. DOI: 10.1016/j.ajo.2005.07.022
Source: PubMed

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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    • "Theodossiadis et al. studied 41 patients with LMH and reported a mean decline of 6.4% in visual acuity (VA) after 37.1 months of observation (Theodossiadis et al. 2009). Only a limited number of reports on vitrectomy results in LMH patients have been published and most studies reported favourable outcomes (Hirakawa et al. 2005; Witkin et al. 2006, 2010; Kokame & Tokuhara 2007; Garretson et al. 2008; Androudi et al. 2009; Michalewska et al. 2010; Casparis & Bovey 2011; Figueroa et al. 2011). However, whether it is worthwhile to attempt a surgical treatment for LMH remains a controversial issue. "
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    ABSTRACT: Purpose: Visual loss due to lamellar macular holes has been considered insuperable in the past. The authors report anatomic and functional improvement after surgery for an inner lamellar macular hole. Methods: A 47-year-old woman with mild nuclear sclerosis and posterior subcapsular cataract and an inner lamellar macular hole presented with low visual acuity unexplained by the degree of cataract. She underwent phacoemulsification with intraocular lens implantation, vitrectomy, internal limiting membrane peeling, and gas tamponade. Results: Pre- and postoperative biomicroscopic examination and optical coherence tomography confirmed anatomic restoration of the foveal contour that was associated with marked improvement in visual acuity, maintained over the follow-up period of 7 months. Conclusions: Surgery may be an effective option for inner lamellar macular holes causing significant visual impairment.
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