SURGICAL-MANAGEMENT BY VITRECTOMY AND AUT OLOGOUS SERUM OF 36 FULL-THICKNESS IDIOPATHIC MACULAR HOLES

Purpose To analyse the surgical results of a second series of full thi ckness idiopathic macular hole operated with autologous serum as adjuv ant therapy, and to compare them to the results of a first series with out autologous serum and the results of literature. Methods In a serie s of thirty-six patients, autologous serum has been used as healing ad juvant therapy. The surgical procedure included a posterior and periph erical vitrectomy combined with posterior hyaloid separation, fluid-ai r exchange, autologous serum injection, and final flushing with 40% su lfur hexafluoride. The patients then maintained strict face-down posit ion post-operatively for a minimum of ten days. Results Anatomic succe ss was obtained in twenty-nine cases of thirty-six patients (80%), wit h an anatomic success rate of 100% for the stage 2 holes. Twenty-nine patients had a pre and postoperative measurable visual acuity. Among t hese twenty-nine patients, median postoperative visual acuity was 20/7 0, compared with 20/125 preoperatively. Final visual acuity was improv ed in twenty-seven patients (75%), was stable five times (14%), and de clined four times (11%). Among the twenty-nine anatomic successes, twe nty-four (85%) improved their visual acuity. Complications were rare, and observed in the same percentage as described in literature. No com plication in relation to autologous serum was noticed. Conclusion Auto logous serum is an inexpensive, easy to obtain, healing adjuvant thera py. It seems improving the surgical results like the other adjuvants d escribed in the literature.