Macular Hole Closure Without Endotamponade Application

Abstract

Purpose: We describe an alternative vitreoretinal technique that allows for the macular hole closure without filling the vitreous cavity with gas.

Methods: A prospective interventional one-center case series from March 2019 to January 2020. The patients underwent the formation of viscoelastic-assisted temporal internal limiting membrane flap without any gas endotamponade. Preoperative and postoperative visual acuity and foveal structure in optical coherence tomography images were evaluated.

Results: Macular hole closure was achieved with a single procedure in 11 of 12 eyes with no endotamponade application. Preoperative, mean best-corrected visual acuity was 1.11 (Snellen equivalent 20/258) ± 0.28 logarithm of the minimal angle of resolution (range 1.398-0.523). We were able to assess visual acuity as early as on the first postoperative day in all patients. It ranged from 1.398 to 0.523 logarithm of the minimal angle of resolution (Snellen equivalent 20/500-20/67) with a mean of 0.97 (20/186) ± 0.29. Final best-corrected visual acuity was 0.31 (Snellen equivalent 20/40) ± 0.18 (range 0.699-0.1) at the end of the 3-month follow-up.

Conclusion: This technique avoids the application of any tamponade, does not require positioning, and seems to provide macular hole closure rates similar to those of traditional vitrectomy with gas.