Pars plana vitrectomy with air tamponade for the treatment of medium‐large macular holes

Abstract

Background: To evaluate the surgical outcomes of pars plana vitrectomy (PPV) with air tamponade in medium-large macular holes (MHs). Methods: Data for 26 eyes of 26 consecutive patients with medium-large full-thickness MHs (> 400 μm) who underwent PPV, internal limiting membrane (ILM) peeling, and sterile air tamponade were studied retrospectively. Best-corrected visual acuity and the closure rate were noted. The follow-up period was one to 20 months (median, four months). Results: The age range of the patients was 53-73 years (median, 65 years). The mean minimum diameter of the MHs was 550 AE 99 μm. Prior to surgery, 10 eyes (38 per cent) were stage three, and 16 eyes (62 per cent) were stage four. The pre-operative symptom duration ranged from one month to 24 months (median, four months). Twenty-four MHs (92.3 per cent) were successfully closed after a single operation. Two (7.7 per cent) patients had a persistent MH. The average visual acuity, calculated as the logarithm of the minimal angle of resolution, improved from 1.44 AE 0.45 pre-operatively to 0.54 AE 0.29 at the end of the follow-up period (p < 0.001, paired t-test). Conclusion: Vitrectomy with ILM peeling and sterile air tamponade is an effective and safe surgical technique for managing medium-large MHs with a shorter history and does not require intravitreal long-acting gas tamponade while maintaining a long-term, face-down position.

Translation of hyaluronic acid–based vitreous substitutes towards current regulations for medical devices

“…C 8 F 18 and F 6 H 8 ) (Barthelmes & Chandra, 2015; Kirchhof et al, 2002) and gases (e.g. SF 6 , air) (Cheng et al, 2020; Kim et al, 2008) are currently in clinical use. However, compared with the native human vitreous, these endotamponades deviate in hydrophilicity, refractive index and density, potentially leading to various complications such as emulsification, blurred vision, increased intraocular pressure, prolonged inflammation, cataract formation or the need for additional surgery (in cases where the tamponade must be removed).…”

Novel vitreous substitutes: the next frontier in vitreoretinal surgery

“…C 8 F 18 , F 4 H 5 ) [2,3] and gases (e.g. SF 6 , air) [4][5][6][7] are utilized as tamponading fillers after the removal of the native vitreous. Current clinically used endotamponades are effective in promoting retinal reattachment, but deviate from the hydrophilicity, refractive index and density of human vitreous, leading to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery.…”