Kelly and Wendel1 have applied the techniques of pars plana vitreous surgery combined with air-fluid exchange to the problem of idiopathic macular hole and have conducted a pilot study of 52 patients treated with this procedure. They were able to close the macular hole and promote resolution of the surrounding cuff of subretinal fluid in 30 of the 52 patients, a surgical success rate of about 60%. Of the 30 patients operated on successfully, 22 had visual improvement of two lines or more, and only one had decreased postoperative visual acuity. However, since the follow-up period was short and cataracts are known to develop in a high percentage of patients following a similar procedure for the removal of epiretinal membrane, it is likely that further losses in visual acuity will develop secondary to cataract.2 In addition, although there was no concurrent control group, none of the 22 patients
Fine SL. Vitreous Surgery for Macular Hole in Perspective: Is There an Indication? Arch Ophthalmol. 1991;109(5):635–636. doi:10.1001/archopht.1991.01080050049026
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