Purpose To assess the efficacy of pars plana vitrectomy,autologous platelet concentrate and gas tamponade for the treatment of full-thickness idiopathic macular holes. Methods The procedures consisted of pars plana vitrectomy with removal of posterior cortical vitreous，air-fluid exchange, instillation of autologous platelet concentrate onto the posterior pole and 20%～30%SF6 tamponade,were performed in treating 6 eyes of 6 patients with idiopathic macular holes. The patients were instructed to lie in a supine position for l hour after surgery,then adviced to remain in a facedown position for 2 weeks. Results Flattening of the surrounding retina and closure of the hole were achieved postoperatively in all the 6 affected eyes.Visual acuity improved two lines or more in 5 eyes (83.3%).Four eyes(66.7%)reached a postoperative visual acuity of 0.3 or more. Retinal detachment ocurred in one eye owing to peripheral new hole formation. Conclusion Pars plana vitrectomy, autologous platelet concentrate and gas tamponade for the treatment of full-thickness idiopathic macular holes are able to close macular hole and improve the visual acuity. (Chin J Ocul Fundus Dis,1998,14:14-15)
ObjectiveTo observe the therapeutic effect of vitrectomy combined with single-layer inverted internal limiting membrane (ILM) flap covering technique for rhegmatogenous retinal detachment (RRD) complicated with macular hole (MH).MethodsA retrospective case analysis. From January 2015 to August 2019, 29 eyes of 29 patients with RRD and MH diagnosed in the First People's Hospital Affiliated to Shanghai Jiaotong University were included in this study. There were 16 males (16 eyes) and 13 females (13 eyes). All the eyes were peripheral RRD and involving the macular area, while complicated with MH and proliferative vitreoretinopathy in stage less than C. All the eyes were examined by BCVA and OCT. The BCVA examination was performed using the Snellen visual acuity chart, which was converted into logMAR visual acuity. Before 2017, 18 eyes were treated with vitrectomy combined with ILM peeling (ILM peeling group); after 2017, 11 eyes were treated with vitrectomy combined with single-layer inverted ILM flap covering technique (ILM inverted group). The differences of age (t=0.360), onset time (t=1.235), number of holes except MH (t=0.060), RRD range (t=1.232), gas filled eyes (χ2=0.324) between the two groups were not statistically significant (P＞0.05). The average follow-up time after surgery was 4.5 months. The BCVA, retinal reattachment and MH closure at the last follow-up in the two groups were comparatively observed. U-shaped or V-shaped retina was defined as MH closure.ResultsAt the last follow-up, retinal reattachments were achieved in all the eyes. In ILM peeling group, 5 eyes (27.8%, 5/18) were completely closed in typeⅠ. In ILM inverted group, 9 eyes (81.8%, 9/11) were completely closed in typeⅠ. There was a statistically significant difference of closure rate in type Ⅰ closure between the two groups (χ2=5.968, P=0.015). The mean logMAR BCVA in ILM peeling group and ILM inverted group were 1.24±0.28 and 0.97±0.39, respectively. The difference of logMAR BCVA between the two groups was statistically significant (t=2.179, P=0.038).ConclusionVitrectomy combined with single-layer inverted ILM flap covering technique can increase the BCVA and MH closure rates in RRD patients with MH.