TREATMENT OF MACULAR HOLES BY VITREOUS SU RGERY

Purpose To assess the benefit of vitreous surgery in treating patients with full thickness macular holes (stages II to IV from Gass), we rep ort anatomic and visual statements before and after operation in a ser ie of 12 consecutive eyes (3 holes stage II and 9 holes stage III). Me thods Visual acuity and anatomical status of the eye before and after the operation were retrospectively reviewed. Surgery included vitrecto my with care to remove the posterior cortical vitreous and relief of a ll tangential tractions at the posterior pole, retinal tamponade with intraocular gas and face down position for one week. Results Postopera tively anatomic succes was achieved in 83% cases. Mean preoperative as postoperative visual acuity was 0.4, but postoperative visual acuity was improved at least one line in 66% cases. A secondary cataract was observed in 42% cases within 3 months postoperatively and a transient postoperative intraocular hypertonia (30 to 50 mm Hg) was found in 83% cases within 3 days after the operation. It could be succesfully trea ted in each case with diamox p.o. No case of retinal ischemia was obse rved. Conclusions Macular hole surgery provides retinal reattachement and meaningful improvement in visual acuity in selected cases. Vitreou s surgery is the treatement of choice for constitued macular holes.