Anatomical and functional results of pars plana vitrectomy+ ILM peeling+ gas endotamponade in patients with idiopathic stage 4 macular hole

Abstract

Aim: To evaluate the anatomical and functional results in cases underwent 23-gauge pars plana vitrectomy (PPV) due to idiopathicstage 4 macular hole.Material and Methods: 17 eyes of 17 patients who underwent PPV due to idiopathic stage 4 macular hole between March 2013 andMarch 2016 at İnönü University Turgut Özal Medical Center Department of Ophthalmology were included in the study. The medicalrecords of the patients were retrospectively reviewed. Macular hole staging was performed according to biomicroscopic examinationand optical coherence tomography findings. Anatomical success was evaluated according to the condition of the macular hole afterthe surgery and functional success was evaluated according to the visual acuity.Results: 9 (53%) of the cases were females and 8 (47%) were males, the mean age was 66.6 ± 6.6 (55-81). PPV, internal limitingmembrane (ILM) peeling and gas tamponade were applied to all cases. The mean follow-up period was 13.9±9.7 (4-30) months. ILMpeeling was performed using trypan blue in three (17.6%) of the cases, brillant blue in 4 (23.5%) of the cases and membrane bluein 10 (58.8%) of the cases. Three cases (17.6%) were treated with C3F8 and 14 cases (82.3%) with SF6 gas tamponade. The meanpreoperatively best-corrected visual acuity (BCVA) was 0.08±0.06 (0.03-0.2) and the mean postoperatively BCVA was 0.16±0.15(0.03-0.5). Visual acuity did not change in two eyes (11.7%) and decreased in two eyes (11.7%). Macular hole had not closed in fourpatients (23.5%).Conclusion: 23 gauge PPV, ILM peeling and C3F8 or SF6 gas tamponade provides anatomical and functional success in the treatmentof idiopathic stage 4 macular hole.