Surgical treatment of retinal detachment from macular hole

Abstract

Six cases of retinal detachment from the macular hole were treated by a procedure including closed vitrectomy, air-fluid exchange, and prone positioning of the patient. All of these detachments were of the idiopathic type. Five patients had myopia ranging from -13 to -20 diopters; one was emmetropic. The initial success rate can be considered 100%: in all six cases the retina remained attached during follow-up periods ranging from 4-10 months at least. One later recurrence was not caused by the macular hole. This new technique, which allows permanent releasing of vitreous traction and temporary closure of the hole, shows that idiopathic retinal detachment is caused by vitreous traction.

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“…Furthermore the technical difficulties of these surgical strategies made them poorly reproducible. Moreover, in the same years, endobulbar surgery was proving useful in difficult cases of RD associated with MMH: in 1986, Vallat presented a series of five patients, in which PPV, air-fluid exchange and prone postoperative positioning was adopted, with an initial 100% success rate and only a late recurrence of RD, not caused by MH [19]. With the advent of new instruments for endobulbar surgery, Oshima confirmed PPV and gas with the use of the Tano scraper for epiretinal membrane removal: in his series of six eyes, the author Their visual acuity, expressed in logMar, increased from 1.39 ± 0.12 before surgery to 1.18 ± 0.13 after surgery.…”