Foveal Lucency with Different Gas Tamponades in Surgically Closed Macular Holes


The presence of foveal lucency (FL), a hyporeflective space underlying the fovea with continuity of the inner retinal layers after surgery – and/or disruption of outer retinal layers such as the ellipsoid layer or the external limiting membrane have been described in the course of the macular hole closure. Given the descriptive nature of previous studies in small cohorts of patients, the prevalence and the clinical impact of these findings remains uncertain.

The aim of our study was to evaluate the prevalence of foveal lucency (FL) in surgically closed full thickness idiopathic macular hole by spectral domain optical coherence tomography (SD- OCT).

We conducted a retrospective review of electronic medical records of 142 eyes of 132 patients that underwent pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling and gas tamponade for idiopathic (senile) macular hole.

Anatomical success and FL rates assessed by SD-OCT, mean preoperative and postoperative best-measured visual acuity (BMVA) and surgical details were examined.

SD-OCT confirmed closed holes with FL in 33.7% (34/101) of eyes at 1 month, 7.3% (9/123) at 3 months, 4.6% (6/129) at 6 months and 3% (4/133) at 12 months.

Prevalence of FL in closed holes at month 1 was lower in C3F8-treated eyes (9.5%, 2/21) compared to C2F6 (40.9%, 18/44, p = 0.03) and SF6-treated eyes (38.9%, 14/36, p = 0.05).

No differences were observed at month 3.

No differences in BMVA change were observed between closed holes with or without FL at month 1 (-0.14 ± 0.19 vs -0.11 ± 0.23, p = 0.48) or any of the other time points.

In summary, temporary FL is a prevalent feature in successfully closed macular holes. Eyes treated with C3F8 gas had lower rates of FL at month 1 than C2F6 and SF6-treated eyes. The presence of FL in closed holes does not appear to have a significant effect on visual outcomes.



Ahmed Sallam
Little Rock, United States
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