Clinical observation of vitrectomy combined with room air-filled on traumatic macular hole

Abstract

Objective To observe the effects of vitrectomy combined with room air-filled on trau-matic macular hole. Methods A retrospective comparative study included 17 patients (18 eyes) with traumatic macular hole treated by surgery between January 2013 and January 2016. Sixteen eyes treated with inner limiting membrane peeling with vitreous cutting operation and vitreous was filled with room air. Patients were asked to sleep in prone position. Macular hole was observed by OCT during the 6-14 months’ follow up. The best corrected visual acuity, hole closure rate, the degree of visual distortion before and after surgery and complications during and after operation were recorded to discuss clinical significance and value about traumatic macular hole after room air tamponade. Results Spontaneous closure of traumatic macular hole was 2 eyes. At the end of the follow up, vision of 15 eyes in 16 eyes improved. The rate of visual acuity improvement was 93.8%. Vision of 12 eyes in 16 eyes improved 2 lines (75.0%). OCT confirmed that macular holes in 13 eyes (81.25%) were completely closed in one month post-operation, and relapse didn’t appear in the follow-up. The mean prone posturing period was 3.5±0.4 days. The degree of visual distortion reduced significantly. All patients’ surgery was successfully completed, no serious intraoperative and postoperative complications. Conclusions Inner limiting membrane peeling with vitreous cutting operation may effectively treat traumatic macular hole and improve the best corrected visual acuity. This study shows that room air tamponade can obtain good closure rate, recovery of visual functions, a short time in the prone position and no any serious surgical complications for traumatic macular hole. Room air tamponade is recommended way after vitrectomy in traumatic macular hole. Key words: Traumatic macular hole; Vitrectomy; Room air; Spectral domain optical coherence tomography (SD-OCT)