TREATMENT OF PERSISTENT MACULAR HOLES WITH HEAVY SILICONE OIL

Background/Purpose:To determine anatomical success and best-corrected visual acuity after secondary surgery with heavy silicone oil tamponade in patients with persistent full-thickness macular holes.Methods:In this retrospective study, 63 eyes with persistent full-thickness macular holes after primary pars plana vitrectomy and internal limiting membrane peeling underwent secondary surgery with heavy silicone oil tamponade. Macular spectral domain optical coherence tomography and best-corrected visual acuity measurements were performed during the follow-up.Results:Fifty of 63 eyes (79.4%) achieved anatomical success. In eyes achieving anatomical success, best-corrected visual acuity before primary vitreoretinal surgery was significantly better (0.77 [similar to 20/125 Snellen] +/- 0.24 [1.3-0.3] logarithm of the minimum angle of resolution) compared with eyes not achieving anatomical success (0.88 [similar to 20/160 Snellen] +/- 0.17 [1.1-0.6] logarithm of the minimum angle of resolution, P = 0.044). Minimum linear diameter of full-thickness macular holes was significantly smaller in eyes achieving anatomical success, both before primary (403.4 +/- 128.7 [199.0-707.0] mu m vs. 568.1 +/- 209.1 [307.0-953.0] mu m, P = 0.009) and secondary surgery (464.1 +/- 215.0 [178.0-1,521.0] mu m vs. 663.3 +/- 228.5 [451.0-1,301.0] mu m, P = 0.010). Patients remaining phakic during all three surgeries did not benefit from best-corrected visual acuity improvement, although anatomical success was achieved.Conclusion:Heavy silicone oil tamponade in secondary surgery for persistent full-thickness macular holes is a safe and efficient surgical method. Best-corrected visual acuity and minimum linear diameter before surgery may be indicators for anatomical success.

Automated summary

This study found that secondary surgery with heavy silicone oil tamponade is a safe and efficient method for treating persistent full-thickness macular holes. Best-corrected visual acuity and minimum linear diameter before surgery may serve as indicators for anatomical success.