SUCCESSFUL CLOSURE OF TRAUMATIC MACULAR HOLES

Abstract

Purpose: To establish the efficacy of vitreoretinal surgery without the use of transforming growth factor–beta or autologous platelet concentrate in the repair of traumatic macular holes. Methods: This retrospective review consisted of 16 eyes from 16 consecutive patients treated by five vitreoretinal surgeons at a single institution between 1993 and 1997. Intervention included pars plana vitrectomy with creation of posterior vitreous detachment, placement of 14% to 16% C3F8 gas, and postoperative face-down positioning. Ten eyes received intraoperative autologous plasmin to facilitate formation of posterior vitreous detachment. Main outcome measures were anatomic closure rate and visual outcome. Results: Anatomic closure of the macular holes was achieved in 15 (94%) of 16 eyes, with an average follow-up of 7 months. Six (38%) eyes achieved visual acuity of 20/40 or better. Visual acuity improved by 2 or more lines in 11 (69%) of 16 eyes. The average preoperative IogMAR-converted visual acuity of 20/175 improved to 20/60 postoperatively. Conclusion: Traumatic macular holes can be closed successfully with substantial visual recovery without the use of transforming growth factor–beta or platelet concentrate.