Macular hole surgery without routine membrane excision or use of adjuvants

Purpose: To present results of macular hole surgery without adjunctive trea tment or routine membrane dissection, but with a long duration tamponade. Methods: Fifty-one consecutive eyes underwent surgery with vitrectomy. Memb rane peeling was performed only when traction was obvious. Pure perfluoropr opane gas was injected as a tamponade followed by prone positioning for two weeks. All eyes were examined with scanning laser ophthalmoscopy (SLO) bef ore and after surgery. Results: The macular hole was closed successfully in 48 eyes (94%) after on e procedure. Visual acuity improved to 0.50 or more in 18 eyes (35%), Impro vement of two or more lines was achieved in 35 eyes (69%), Two eyes develop ed retinal detachments and two eyes showed post-operative visual field defe cts previously reported after macular hole surgery. Conclusion: In this series the results and complication rates compare favou rably with other reports of macular hole surgery. However, in contrast to m any previous studies, membrane peeling was not done. The extent and long du ration of the gas tamponade was thought to be important for the surgical su ccess.