To assess the anatomic outcome and visual acuities at follow-up after pars plana vitrectomy in the management of stage 2 macular holes.
Retina Consultants, Ltd, St Louis, Mo. Patients: Thirty-three patients, aged 43 to 75 years, with stage 2 macular holes.
Total pars plana vitrectomy with separation of the posterior hyaloid membrane and injection of intraocular gas followed by postoperative facedown positioning.
Main Outcome Measures:
Visual acuity and anatomic appearance of the macular hole.
Postoperatively, 20 (61%) of 33 eyes attained a visual acuity of 20/50 or greater. Twenty (61%) of 33 eyes showed an improvement in visual acuity, while nine (27%) of 33 were stable. Four (12%) of 33 eyes showed a decline in postoperative visual acuity with progression to a stage 3 macular hole. Twenty-five (76%) of 33 eyes showed stabilization or improvement in the appearance of the macular hole.
Pars plana vitrectomy in conjunction with postoperative intraocular gas tamponade may result in visual and anatomic stabilization or improvement in eyes with stage 2 macular holes. However, because of limited natural history data, it is unknown whether these results are any better than those that might occur without surgery.
Ruby AJ, Williams DF, Grand MG, Thomas MA, Meredith TA, Boniuk I, Olk RJ. Pars Plana Vitrectomy for Treatment of Stage 2 Macular Holes. Arch Ophthalmol. 1994;112(3):359-364. doi:10.1001/archopht.1994.01090150089029