A face-down postoperative position is highly recommended in holes larger than 400 microm. The size of the idiopathic MH seems to be an important factor affecting outcome.
Aims: To evaluate the rate of retinal detachment after macular surgery. Methods: A retrospective non-randomised study of 634 macular surgery procedures was undertaken in two academic centres. Idiopathic macular hole (IMH) surgery (n = 272) and epiretinal membrane (ERM) surgery (n = 362) were performed between 2000 and 2003. We noted the anatomical and functional results of these procedures and we studied serious complications excluding cataract. Results: Minimum follow up was 1 year. No retinal detachment (RD) occurred in patients presenting with an intraoperative or preoperative successfully treated retinal break (RB). The rate of RD occurring after IMH surgery was higher than after the ERM surgical procedure (6.6% vs 2.5%, p = 0.02). The rate of RD was higher in patients presenting with stage 2 and 3 IMH than with stage 4 IMH. However, lens status as well as preoperatively treated RD did not influence the rate of RD after macular surgery. Conclusion: Retinal detachment remains the most common serious complication of macular surgery. Surgical detachment of the posterior vitreous face and associated peripheral retina anomaly seem to increase the rate of this complication. Careful examination of the peripheral retina is a key issue in preventing retinal detachment occurring after macular surgery.T he most frequently reported complications of macular surgery are cataract, high intraocular pressure (IOP), retinal vascular occlusion, intraocular inflammation, endophthalmitis, cystoid macular oedema, phototoxicity, macular holes, retinal breaks (RBs), retinal detachment (RD) and surgery failures.
1-5The number of operations on the macula has increased over the last 10 years and many authors have reported different procedures for the treatment of idiopathic macular hole (IMH) and epiretinal membrane (ERM). [6][7][8][9][10][11][12] For the most part, these studies aimed to specify the anatomical and functional results in order to determine the best procedure. The complications of these procedures were mentioned but few attempts have been made to discuss their risk factors.
Primary vitrectomy without scleral buckling is an effective procedure to treat pseudophakic retinal detachment. Less experienced surgeons need sufficient time to achieve acceptable success rates, reflecting the learning curve for this procedure.
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