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Case Reports
. 2011 May;2(2):149-54.
doi: 10.1159/000328752. Epub 2011 May 10.

Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography

Atsushi Hayashi  1 , Takaaki Yagou, Tomoko Nakamura, Kazuya Fujita, Miyako Oka, Chiharu Fuchizawa
Affiliations
Case Reports

Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography

Atsushi Hayashi et al. Case Rep Ophthalmol. 2011 May.

Abstract

Purpose: To examine anatomical changes in idiopathic macular holes during surgery using handheld spectral-domain optical coherence tomography (SD-OCT).

Methods: Five eyes of 5 patients who underwent surgery for the repair of idiopathic macular holes were examined. The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade. Intraoperative SD-OCT images of the macular holes were obtained after ILM removal and under fluid-air exchange using a handheld SD-OCT. From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.

Results: All macular holes were successfully closed after the primary surgery. The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD. In 1 eye with a stage 3 macular hole, SD-OCT images revealed that the inner edges of the macular hole touched each other under fluid-air exchange.

Conclusion: Fluid-air exchange significantly reduced MHBD during surgery to repair macular holes. Fluid-air exchange may be an important step for macular hole closure as it reduces the base diameter of the macular hole.

Keywords: Base diameter; Intraoperative OCT; Macular hole; Spectral-domain OCT.

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Figures

Fig. 1
Fig. 1
SD-OCT images of a macular hole from case 1. a Macular hole after ILM removal. b Macular hole under fluid-air exchange. The inner edges of the macular hole touched each other. c Macular hole at 7 postoperative days, showing a bridge formation.
Fig. 2
Fig. 2
SD-OCT images of macular holes from cases 2 and 3. a Macular hole from case 2 under fluid-air exchange. b Macular hole from case 3 under fluid-air exchange. The macular holes were open under fluid-air exchange.
See this image and copyright information in PMC

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