PHOTOCOAGULATION AND FLUID-GAS EXCHANGE TO TREAT PERSISTENT MACULAR HOLES AFTER PRIOR VITRECTOMY - A PILOT-STUDY

Objective: This study aimed to determine the efficacy of photocoagulat ion to the retinal pigment epithelial (RPE) cells and fluid-gas exchan ge (FGX) in the treatment of persistent macular holes. Design: A clini cal trial. Participants: Thirteen eyes of 12 patients who had undergon e photocoagulation to the RPE and FGX for persistent macular holes aft er initial vitrectomy and gas tamponade were examined. All eyes had pe rsistent full-thickness macular holes (diameter range, 290-820 mu m; 6 10 +/- 190, mean +/- standard deviation) and no vitreous cortex around the holes on biomicroscopic examination, Intervention: Argon laser ph otocoagulation was applied to the RPE in the hole bed, and FGX with 20 % sulfur hexafluoride was then performed, followed by 2 weeks with the patient in a prone position. The follow-up period of the patients ran ged from 3 to 18 months (10.2 +/- 4.2; mean +/- standard deviation). M ain Outcome Measures: Anatomic success and final visual outcome were m easured. Results: Macular holes were closed successfully after treatme nt in 12 (92%) of 13 eyes, and visual acuity improved 2 or more lines in 6 eyes (46%), Two eyes (15%) attained visual acuities of 20/40 or b etter, and seven eyes (54%) attained 20/67 or better visual acuity, Th ere were no intraoperative complications. Cataract formation or progre ssion was recognized during follow-up in five (83%) of six phakic eyes . Conclusions: Although this study includes only a small number of pat ients, it suggests that photocoagulation and FGX can be effective in t he treatment of persistent macular holes.