Temporary silicone oil tamponade for persistent macular holes: a multicentre study

Abstract

Background Persistent full-thickness macular holes (FTMHs) following primary surgery represent a therapeutic challenge. Various surgical treatment approaches have been proposed. This study evaluates anatomical and functional outcomes of a temporary silicone oil tamponade in persistent FTMH in a larger cohort. Methods In a retrospective multicentre study, we included consecutive patients with persistent FTMH following vitrectomy with inner limiting membrane peeling and gas tamponade who were treated by a temporary silicone oil tamponade. FTMH morphology in optical coherence tomography, minimum linear diameter (MLD), closure rate and best-corrected visual acuity (BCVA) change were assessed. Results A total of 102 eyes of 102 consecutive patients were included. Median duration of silicone oil tamponade was 16.6 weeks (interquartile range (IQR) 12.0–22.1). Closure of the macular hole (flat/closed configuration) was achieved in 92.2% of eyes. Median BCVA improved significantly from 1.00 logMAR (IQR 0.70–1.15) to 0.70 logMAR (IQR 0.49–1.00; p<0.0001). Mean preoperative MLD was 460.7 µm (±194.2; range 136–1016), with significantly higher MLD in eyes with unsuccessful (614.4 µm±250.4) compared with successful (446.9 µm±183.9; p=0.019) silicone oil treatment. Conclusion Treatment of persistent FTMH with a temporary conventional silicone oil tamponade without retinal manipulation or postoperative positioning results in a high anatomical success rate and significant mean BCVA improvement. Success rate decreases with higher FTMH size. Data are available upon reasonable request.