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Case Reports
. 2014 Mar;62(3):363-5.
doi: 10.4103/0301-4738.116452.

Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

Pukhraj Rishi  1 , Sumanth Reddy, Ekta Rishi
Affiliations
Case Reports

Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

Pukhraj Rishi et al. Indian J Ophthalmol. 2014 Mar.

Abstract

A 65-year-old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full-thickness macular hole in left eye; confirmed by optical coherence tomography (OCT). Patient underwent phacoemulsification with intraocular lens (IOL) implantation, vitrectomy, internal limiting membrane (ILM) peeling and 14% C ₃ F ₈ gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid-gas exchange with 14% C ₃ F ₈ gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re-surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re-surgery than those without. However, larger studies with longer follow-up are required to validate this finding.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Baseline (a) Color fundus photo of the left eye showing a full-thickness macular hole (b) OCT scan is confirmatory of macular hole
Figure 2
Figure 2
Six weeks after primary surgery. OCT showing type 2 closure of macular hole with cuff of subretinal fluid at the edges of the hole. Basal diameter of the macular hole is reduced
Figure 3
Figure 3
Two weeks after repeat surgery (a) Color fundus photo showing completely closed macular hole (b) OCT is confirmatory of type 1 closure of the macular hole
See this image and copyright information in PMC

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