Fourier-Domain Optical Coherence Tomography Imaging of Gas Tamponade Following Macular Hole Surgery

Abstract

In this prospective study, the authors report fourier-domain optical coherence tomography (FD-OCT) imaging of gas-inner retinal tamponade following surgery for full-thickness macular hole and evaluate postoperative posturing based on FD-OCT findings. Patients underwent FD-OCT 1 day after pars plana vitrectomy, internal limiting membrane peel, and gas injection. Three-dimensional FD-OCT and high-resolution line scans demonstrated gas-inner retinal tamponade across the macula with the apex of tamponade located at the fovea. Inner and outer retina landmarks could be accurately identified along the curvature of the eye using FD-OCT in x-, y-, and z-planes. No patients required face-down positioning postoperatively based on FD-OCT findings. Satisfactory gas-inner retinal tamponade with 75% fill of any gas agent in the upright position was observed. Full-thickness macular hole closure was successful in 90% at 1 day, 2 weeks, and 12 weeks postoperatively. These FD-OCT findings may support decisions to not require face-down positioning postoperatively.

Special Adjuncts to Treatment

“…[121][122][123][124] A recent study using spectraldomain optical coherence tomography (OCT) to capture hole closure showed that following vitrectomy with ILM peeling and gas tamponade, 77% closure rate was achieved as fast as on postoperative day 1. 126 This supports the idea of using a gas with shorter intraocular longevity such as air, and obviates the need for posturing. 126 This supports the idea of using a gas with shorter intraocular longevity such as air, and obviates the need for posturing.…”

Face-Down Positioning Following Macular Hole Surgery: Pros and Cons

“…28,29 Additionally, OCT data have shown that hole closure occurs as early as 24 hours into the postoperative course. 30 –32 This furthers the case against long periods of postoperative FDP.…”