Visual and anatomical outcome of macular hole surgery at a tertiary healthcare facility.

Komalta Kumari,Muhammad Ali Tahir,Alyscia Miriam Cheema

doi:10.12669/pjms.335.13089

Komalta Kumari, Muhammad Ali Tahir + Show 1 more

Open Access

https://doi.org/10.12669/pjms.335.13089

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Abstract

Objective:To assess visual and anatomical outcome of full thickness macular hole (FTMH) surgery with ILM peeling using brilliant blue G dye.Methods:Thirty patients who had clinically evident macular hole were selected. Pre-operative Optical Coherence Tomography (OCT) was done. In all cases vitrectomy was performed via 23guage 3 ports pars plana (3PPV) vitrectomy system and Brilliant blue G dye, 0.5ml dye was injected over macula which resulted in light blue stain of ILM and peeling was performed around hole in circular motion and after gas fluid exchange gas tamponade with SF6 was done. Final visual and anatomical outcome was measured as postoperative BCVA and postoperative OCT at three months respectively. Descriptive statistics were computed. Paired t-test was applied. P value≤0.05 were considered as significant.Results:There were 12 male and 18 female patients. The mean age was 57.40±4.76 years. The mean size of macular hole was 452.20±242.33μm. The mean duration of symptoms was 16.73±13.49 weeks. Mean pre operative BCVA was 1.30±0.73 log MAR and post operative was 0.51±0.23 log MAR. Mean increased BCVA was found to be 0.22±0.13 log MAR. Primary closure of hole was achieved in 29(96.7%). Significant mean difference was found in pre operative and post operative BCVA.Conclusion:Brilliant blue G exhibits sufficient staining qualities and safety profile to peel ILM in the management of full thickness macular hole with significant visual and anatomical improvement.

Highlights

A macular hole is a defect at the fovea with interruption of all retinal layers from the internal limiting membrane1
Total 30 patients with idiopathic full thickness macular hole (FTMH) were selected from retina clinic in ophthalmology department of Jinnah Postgraduate Medical Center, Karachi, Pakistan from January 2015 to June 2016.After detailed history and ophthalmic examination (IOP measurement, Watzke Allen test, Amsler grid, fundoscopy using +90 Diopter lens and indirect ophthalmoscopy) patients who had clinically evident macular hole and after exclusion of other peripheral retinal tears were selected for 23 guage 3PPV
Brilliant blue G (DORC, international), 0.5ml, dye was injected over macula under BSS which resulted in light blue stain of ILM and peeling was performed around hole in circular motion with the help of ILM peeling forceps via pinch and squeeze method

Summary

Introduction

A macular hole is a defect at the fovea with interruption of all retinal layers (except stage 1A and 1B) from the internal limiting membrane. 1. Dr Komalta Kumari, FCPS (Ophth), MRCSEd (Edin), 2. Dr Muhammad Ali Tahir, FCPS (Ophth), FCPS (VR), 3. Dr Alyscia Cheema, FCPS (Ophth) FRCS (Edin), 1-3: Department of Ophthalmology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. Correspondence: May 7, 2017 May 26, 2017 September 27, 2017 September 28, 2017. (ILM) up to the Retinal Pigment Epithelium (RPE).[1] Macular hole is an important cause of central visual loss and the overall prevalence is approximately 3.3 per 1000 and strong female predominance.[2,3]

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