ABSTRACT: The purpose of this study was to investigate lamellar macular hole formation in six patients after rhegmatogenous retinal detachment repair.
A retrospective review of medical records of patients who underwent primary pars plana vitrectomy for rhegmatogenous retinal detachment repair was performed. Optical coherence tomography characteristics and best-corrected visual acuity were evaluated. Patients who developed lamellar macular hole after pars plana vitrectomy for rhegmatogenous retinal detachment repair were identified.
A total of 1185 eyes underwent pars plana vitrectomy for retinal detachment between 2004 and 2009. Optical coherence tomography evaluation was available in 450 cases. Six of these cases demonstrated lamellar macular hole formation, which was diagnosed by OCT-3. The mean time from retinal detachment surgery to lamellar hole diagnosis was 4.1 months. The presence of an epiretinal membrane on the surface of the juxtafoveal retina was a common finding in all six patients. Visual acuity was improved after successful retinal reattachment and remained unchanged after lamellar hole formation.
Lamellar macular holes developing after pars plana vitrectomy is a rare complication. Stability of optical coherence tomography findings and best-corrected visual acuity after lamellar macular hole formation may be observed for at least two years.
Clinical Ophthalmology 01/2012; 6:571-4.
ABSTRACT: To report on the outcomes of vitrectomy and sulfur hexafluoride (SF(6)) gas tamponade for idiopathic macular holes with 2 days of face-down positioning.
This was a prospective, nonrandomized, observational sequential case-series study on 23 consecutive patients receiving macular hole surgery using 20% SF(6) and advised to stay in a face-down position for 2 days postoperatively (SF(6) group). These patients were compared to 23 consecutive patients who had previously undergone macular hole surgery, had received 14% C(3)F(8), and were advised to maintain a face-down position for 2 days (C(3)F(8) group). Patients in both groups underwent vitrectomy, internal limiting membrane peeling, and fluid gas exchange using either SF(6) or C(3)F(8.) Preoperative and postoperative data included best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography.
At a 6-month follow-up, macular hole closure was noted in 23/23 eyes (100%) and in 22/23 eyes (96%) in the SF(6) and C(3)F(8) groups, respectively. The improvement in visual acuity (measured through Snellen acuity lines both preoperatively until 6 months postoperatively) was 4.08 ± 2.31 (95% confidence interval [CI]: 3.08-5.08) for the SF(6) group and 2.87 ± 2.30 (95% CI: 1.87-3.86) for the C(3)F(8) group; this difference was not statistically significant (P = 0.06).
Vitrectomy with internal limiting membrane peeling and a short-acting gas tamponade using SF(6) with posture limitation for 2 days may give a high success rate in macular hole surgery.
Clinical Ophthalmology 01/2012; 6:1107-12.
ABSTRACT: To report a case of macular hole closure after the exchange of a silicone-oil tamponade with gas C(3)F(8) 14%.
A 64-year-old female patient with a stage IV macular hole underwent a three-port pars-plana vitrectomy and internal limiting membrane peeling. Due to the patient's chronic illness (respiratory problems), a silicone-oil tamponade was preferred. However, the macula hole was still flat opened four months postoperatively. Therefore, the patient underwent an exchange of silicone oil with gas C(3)F(8) 14%. No face-down position was advised postoperatively due to her health problems.
Macular hole closure was confirmed with optical coherence tomography six weeks after exchanging the silicone oil with gas.
Macular hole surgery using a silicone-oil tamponade has been proposed as treatment of choice for patients unable to posture. In our case, the use of a long-acting gas (C(3)F(8) 14%), even without posturing, proved to be more effective.
Case reports in ophthalmology. 05/2011; 2(2):166-9.
ABSTRACT: We present a rare case of ocular leishmaniasis complicated by proliferative vitreoretinopathy in a child with active visceral leishmaniasis.
A 10-year-old boy with active visceral leishmaniasis presented with a 5- day history of redness, photophobia, and blurred vision in his left eye. Visual acuity was measured and the child had a complete ocular examination.
Snellen best-corrected visual acuity (BCVA) was 10/10 in the right eye and 7/10 in the left eye at presentation. Ophthalmic examination of the right eye was normal but the left eye showed clinical signs of panuveitis. Laboratory investigations were negative. Treatment with systemic and local steroids was initiated and clinical improvement achieved. Eight months later, the patient had a relapse of systemic and ocular disease with severe panuveitis in both eyes. A combined tractional-rhegmatogenous retinal detachment was present in the left eye. Pars plana vitrectomy was undertaken in the left eye and the patient was started on systemic and local steroid treatment. Retinal reattachment was achieved postoperatively but visual acuity in the left eye remained poor.
Early diagnosis, prompt systemic and ocular treatment, as well as close ophthalmic examination are essential in such cases.
European journal of ophthalmology 07/2009; 20(1):231-3. · 0.96 Impact Factor