PARS-PLANA VITRECTOMY FOR TREATMENT OF STAGE-2 MACULAR HOLES

Objective: To assess the anatomic outcome and visual acuities at follo w-up after pars plana vitrectomy in the management of stage 2 macular holes. Design: Retrospective. Setting: Retina Consultants, Ltd, St Lou is, Mo. Patients: Thirty-three patients, aged 43 to 75 years, with sta ge 2 macular holes. Intervention: Total pars plana vitrectomy with sep aration of the posterior hyaloid membrane and injection of intraocular gas followed by postoperative facedown positioning. Main Outcome Meas ures: Visual acuity and anatomic appearance of the macular hole. Resul t: Postoperatively, 20 (61%) of 33 eyes attained a visual acuity of 20 /50 or greater. Twenty (61%) of 33 eyes showed an improvement in visua l acuity, while nine (27%) of 33 were stable. Four (12%) of 33 eyes sh owed a decline in postoperative visual acuity with progression to a st age 3 macular hole. Twenty-five (76%) of 33 eyes showed stabilization or improvement in the appearance of the macular hole. Conclusions: Par s plana vitrectomy in conjunction with postoperative intraocular gas t amponade may result in visual and anatomic stabilization or improvemen t in eyes with stage 2 macular holes. However, because of limited natu ral history data, it is unknown whether these results are any better t han those that might occur without surgery.