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March 1994

Pars Plana Vitrectomy for Treatment of Stage 2 Macular Holes

Author Affiliations

From Retina Consultants, Ltd, St Louis, Mo. Dr Ruby is now with Franklin Eye Consultants, Southfield, Mich.

Arch Ophthalmol. 1994;112(3):359-364. doi:10.1001/archopht.1994.01090150089029

Objective:  To assess the anatomic outcome and visual acuities at follow-up after pars plana vitrectomy in the management of stage 2 macular holes.

Design:  Retrospective.

Setting:  Retina Consultants, Ltd, St Louis, Mo. Patients: Thirty-three patients, aged 43 to 75 years, with stage 2 macular holes.

Intervention:  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.

Results:  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.

Conclusions:  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.