Author response: Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

Abstract

Dear Editor, We appreciate the interest of Goel et al.[1] and their remarks in response to our article “Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.”[2] We also congratulate them on their success in achieving closure in two cases of primarily failed macular hole closure as shared in their report. They attribute our interpretation of type 2 macular hole closure in a case with residual foveal defect and cuff of subretinal fluid as incorrect. This needs some clarification. Tornambe et al. have classified macular hole surgery outcomes into three possible situations: Elevated/open, flat/open and flat/closed.[3] The first two situations are recognized as type 2 closure while the third situation is considered as type 1 closure; presence/absence of residual foveal defect being the prime determinant. We would like to reemphasize that the focus of our report was on factors related to the closure of idiopathic macular hole following failed primary surgery. Preoperative optical coherence tomography configuration of the macular hole can offer predictive clues to successful re-surgery.[4] We again thank Goel et al. for bringing up this point thus helping generate clarity on this issue.