Scientific correspondence
Macular hole surgery using silicone oil tamponade
N Karia, A Laidlaw, J West, E Ezra, M Z Gregor
Vitreo-retinal Unit,
Moorfields Eye Hospital, City Road, London EC1V 2PD, UK
Correspondence to: Mr Z Gregor
Accepted for publication 12 March 2001
BACKGROUND/AIMS
Most
surgeons performing macular hole surgery using long acting gas
recommend strict postoperative face down posturing for 10-15 days.
Patients with chronic systemic illness such as arthritis may be unable
to carry out this postoperative regime. Thus there is a need for
alternative techniques that would eliminate such a regime. The authors
review a series of patients who underwent macular hole surgery using
silicone oil without any postoperative posturing.
METHODSA
retrospective case note review was performed of patients who had
undergone macular hole surgery with silicone oil tamponade. The
patients were unable to posture due to chronic illness and had stage 2, 3, or 4 full thickness macular holes. Removal of silicone oil performed
with or without cataract surgery was arranged 3 months or more after surgery.
RESULTS10 eyes of 10 patients underwent surgery. Duration of oil tamponade ranged from 3-9
months. Following oil removal the hole was closed in eight eyes (80%),
of which only three showed any improvement in visual acuity (38%) even
after cataract extraction. All eyes developed cataract to varying
degrees and one eye developed raised intraocular pressure which settled
after oil removal. A serious complication, endophthalmitis, occurred in
one eye following removal of sutures after cataract extraction.
CONCLUSIONThe
anatomical results (80%) in this series are in keeping with those
reported in other studies using gas tamponade. The visual results are
disappointing and less rewarding than those obtained after successful
surgery using gas tamponade.
© 2001 by British Journal of Ophthalmology
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This article has been cited by other articles:
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Mittra, R A, Kim, J E, Han, D P, Pollack, J S
(2009). Sustained postoperative face-down positioning is unnecessary for successful macular hole surgery. Br. J. Ophthalmol.
93: 664-666
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