Martina Rubesova_SCIENTIFIC POSTER 2015

Purpose:

The aim of this study was to evaluate the efficacy of retreatment of macular hole in patients in whom primary pars plana vitrectomy (PPV) did not lead to the anatomical closure of the full-thickness defect, and to analyse the causes of its failure.

Methods:

Patients after primary surgical treatment by pars plana vitrectomy with a peeling of internal limiting membrane (IML) and gas tamponade which did not lead to the anatomical closure of the macular hole underwent retreatment by intravitreal application of gas, or PPV with a stimulation of macular hole edges or pigment epithelium, followed by gas tamponade. Preoperative and postoperative best-corrected visual acuity (BCVA), time delay between primary and secondary surgery, and anatomical and functional efficacy of the treatment were evaluated.

Results:

Between 2007 and 2012, a total of 148 eyes were surgically treated for idiopathic macular hole at the European Eye Clinic Lexum in Prague, Czech Republic, with macular hole stage II in 20%, stage III in 39%, and stage IV in 41% of eyes. Subsequently, 7.4% of eyes (11 eyes of 11 patients) underwent secondary surgery due to the failure in anatomical closure after primary procedure. The mean age of 11 retreated patients was 67.18 ± 8.47 years (range: 53 to 84 years). After the retreatment, anatomical closure of macular hole has been achieved in 8 out of 11 (72.7%) patients. Twelve months after retreatment, best-corrected visual acuity was significantly better when compared with BCVA before primary, as well as before secondary surgery (p=0.004 and p=0.008, respectively).

Conclusion:

Our study showed that repeated surgery of patients with a persistent macular hole is a safe and efficient method which leads to both anatomical and functional improvement. Nevertheless, the general success rate of retreatment was lower compared to that of primary surgery.

Contact Details:

Email: filipova@lexum.cz