Dr. Kumar K S, K08476
A Simple treatment for the complex problem of a reopened(& persistent) macular hole.
Aim : To describe the results of OPD fluid gas exchange(FGE)for recurrent & persisting idiopathic macular holes
Materials & Methods : 14 patients with idiopathic macular holes who had reopening of the macular holes after initial closure or remained open after vitrectomy,ILM peeling & SF6 gas injection were the subjects of this study.There were 10 women & 4 men in this group with an average age of 56.8yrs(40-64yrs).The macular holes had closed successfully following vitrectomy in 8 patients & r eopened between the 7th & 15th postop days while it remained open after surgery in 6 patients. The post op status of the macula was assessed with indirect ophthalmoscopy & contact biomicroscopy as OCT in a gas filled eye was difficult. All patients underwent OPD fluid C3F8 gas (14%) injection using a 2 needle technique where the whole of the vitreous cavity was replaced with nonexpansile C3F8 gas & were advised strict prone positioning.
Results : Successful hole closure was noted in all patients after OPD FGE & the achieved anatomic closure was maintained over an average follow up period of 11 months(6months-2yrs). Progression of lens opacities to the extent of requiring cataract surgery occurred in 3 patients at an average of 5 months after OPD fluid gas exchange.
Conclusions : OPD – FGE is a simple solution to a vexing issue that many times is dealt with more invasive resurgeries (revitrectomy with further peel of ILM , heavy silicon oil injection , inverse ILM flap , autologous platelet concentrate etc ) & works particularly well when the extent of ILM peel during the 1st surgery is deemed adequate.
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