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Surgical Techniques for Refractory Macular Holes

Surgical Techniques for Refractory Macular Holes Surgical Techniques for Refractory Macular Holes Hesham Gabr, MD Dilraj S. Grewal, MD Introduction Until 1991, observation was the standard of care for macular holes (MHs). In 1991, Kelly and Wendel introduced pars plan vitrectomy (PPV) with peeling of any associated epiretinal membrane (ERM) and gas tamponade for primary repair of idiopathic MHs, with a 58% successful closure rate. This seminal work stimulated the interest in refining the surgical techniques. In 1997, Eckart et al proposed the technique of PPV, internal limiting membrane (ILM) peeling with perfluoropropane (C3F8) gas as a tamponade for surgical repair of MH. The results of this technique were impressive with a 92% closure rate. It was postulated that ILM peeling minimizes the epiretinal tangential traction and stimulates a 2,3 strong glial tissue response, which helps with MH closure. While advances in vitreoretinal surgical techniques resulted in high success rates of surgical repair of MH, recurrence or persistence of MH after surgery may still occur. The term refractory MH describes a persistent MH that remains open after surgical repair. In contrast, a reopened MH refers to a MH that closed initially after surgical repair and then reopened. It is important to differentiate between the 2 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Ophthalmology Clinics Wolters Kluwer Health

Surgical Techniques for Refractory Macular Holes

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References (101)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0020-8167
eISSN
1536-9617
DOI
10.1097/iio.0000000000000435
Publisher site
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Abstract

Surgical Techniques for Refractory Macular Holes Hesham Gabr, MD Dilraj S. Grewal, MD Introduction Until 1991, observation was the standard of care for macular holes (MHs). In 1991, Kelly and Wendel introduced pars plan vitrectomy (PPV) with peeling of any associated epiretinal membrane (ERM) and gas tamponade for primary repair of idiopathic MHs, with a 58% successful closure rate. This seminal work stimulated the interest in refining the surgical techniques. In 1997, Eckart et al proposed the technique of PPV, internal limiting membrane (ILM) peeling with perfluoropropane (C3F8) gas as a tamponade for surgical repair of MH. The results of this technique were impressive with a 92% closure rate. It was postulated that ILM peeling minimizes the epiretinal tangential traction and stimulates a 2,3 strong glial tissue response, which helps with MH closure. While advances in vitreoretinal surgical techniques resulted in high success rates of surgical repair of MH, recurrence or persistence of MH after surgery may still occur. The term refractory MH describes a persistent MH that remains open after surgical repair. In contrast, a reopened MH refers to a MH that closed initially after surgical repair and then reopened. It is important to differentiate between the 2

Journal

International Ophthalmology Clinics – Wolters Kluwer Health

Published: Jun 22, 2022

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