Surgical treatment of idiopathic macular holes with a fovea-sparing technique and 20% SF6 gas tamponade

Q4 Medicine

Oftalmologicheskii zhurnal Pub Date : 2023-09-04 DOI:10.31288/oftalmolzh202342125

Інес Буаллагуі, Зоя Анатоліївна Розанова, Микола Уманець

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引用次数: 0

Abstract

Purpose: To assess the macular hole (MH) closure rate and final visual acuity after idiopathic MH treatment with a modified fovea-sparing technique and 20% SF6 gas tamponade. Material and Methods: Fifteen patients (16 eyes; 12 women and 3 men; mean age (standard deviation or SD), 65.5 (5.90 years)) with Gass stage 2 to stage 4 MHs were involved in the study. Before surgery, mean best-corrected visual acuity (BCVA) (SD) was 0.15 (0.09), and mean MH diameter (SD), 437.2 (164.7) µm. Patients underwent surgical treatment with the modified fovea-sparing technique and 20% SF6 gas tamponade of two-week duration and were instructed to maintain a face-down position for a week after surgery. Results: At 1 month after the first surgery, MHs were closed in 11/16 eyes (68.75%). In addition, mean BCVA (SD) in eyes with closed MHs improved significantly from 0.15 (0.09) to 0.48 (0.16) (р = 0.000000). Of the five eyes in which the MH had failed to close after primary fovea-sparing surgery, two received a gas fluid exchange gas tamponade with 15% С3F8, and these patients were advised to maintain a face down position for 3 more weeks. In addition, in another two eyes, the vitreous cavity was revised, and the internal limiting membrane (ILM) was removed by a conventional technique with 15% С3F8 gas tamponade. Moreover, one patient rejected repeat intervention. In the four eyes in which the MH had failed to close after primary fovea-sparing surgery, after a repeat intervention, the MH was closed, and mean BCVA (SD) improved to 0.35 (0.04). There was no significant difference between the eyes in which the MH failed to close and the eyes in which the MH did close after primary surgery in terms of mean MH size (SD) (455 (203) µm versus 415 (155) µm, р = 0.66) or MH duration. Conclusion: A long gas tamponade (longer than 1 week) is required to improve the closure rate with the fovea-sparing ILM peeling technique for idiopathic MHs.

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用中央凹保留技术和20% SF6气体填塞治疗特发性黄斑孔

目的：评估用改良的中央凹保留技术和20%SF6气体填塞治疗特发性黄斑裂孔（MH）后黄斑裂孔闭合率和最终视力。材料和方法：15名Gass 2期至4期MHs患者（16眼；12名女性和3名男性；平均年龄（标准差或SD），65.5（5.90岁））参与了本研究。手术前，平均最佳矫正视力（BCVA）为0.15（0.09），平均MH直径（SD）为437.2（164.7）µm。患者接受了改良的中央凹保留技术和为期两周的20%SF6气体填塞的手术治疗，并被指示在手术后保持面部朝下的姿势一周。结果：在第一次手术后1个月，11/16眼（68.75%）的MHs闭合。此外，闭合MHs的眼睛的平均BCVA（SD）从0.15（0.09）显著改善到0.48（0.16）（р=0.00000）。在原发性中央凹保留手术后MH未能闭合的5只眼睛中，2只接受了含15%С3F8的气体-液体交换气体填充，并建议这些患者再保持面部朝下的姿势3周。此外，在另两只眼睛中，对玻璃体腔进行了矫正，并通过15%С3F8气体填塞的常规技术去除了内界膜（ILM）。此外，一名患者拒绝重复干预。在初次保留中央凹手术后MH未能闭合的四只眼睛中，重复干预后，MH闭合，平均BCVA（SD）提高到0.35（0.04）。初次手术后MH未闭合的眼睛和MH闭合的眼睛在平均MH大小（SD）方面没有显著差异（455（203）µm对415（155）µm，р=0.66）或MH持续时间。结论：保留中央凹ILM剥离技术治疗特发性MHs需要长时间的气体填塞（超过1周）以提高闭合率。

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来源期刊

Oftalmologicheskii zhurnal Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

期刊介绍： Journal of Ophthalmology (Ukraine) contains articles on eye diseases diagnosis and treatment, eye care, eye diseases prevention, history of ophthalmology, organization of eye care to population, technical equipment problems. It is committed to publishing original scientific researches and review articles on theory and practice of Ukrainian and foreign ophthalmology, cases, reviews, inventions, historical and medical reviews. It contains peer-reviews of books on ophthalmology, articles on activity of ophthalmologic societies, congresses and conferences chronicles. Journal is designed to ophthalmologists and scientific researchers in the field of vision physiology and eye diseases clinic.