Features of macular hole closure in the early postoperative period using optical coherence tomography

Purpose: Studying the retina in the early postoperative period after macula r hole surgery is difficult because of the limitation of imaging of the fun dus through a gas tamponade, Silicone oil was shown recently to be an effec tive alternative to gas for macular hole repair, The authors hypothesized t hat optical coherence tomography (OCT) could be performed through silicone oil to study early macular hole closure, Methods: Fourteen patients with idiopathic full-thickness macular holes und erwent repair, including vitrectomy and silicons fill of the vitreous cavit y, Silicone oil was removed 5 to 18 weeks later in a second operative proce dure. Optical coherence tomography images were obtained preoperatively (n = 14), on the first postoperative day (n = 7), after 1 week (n = 4), after 1 month (n = 14), and after silicone oil removal (n = 14), Results: By the first postoperative day, the retina was flat and the hole w as open or closed in all patients, By I month, 9 of 14 patients had flat re tinas and closed holes, whereas the other 5 patients had flat retinas and o pen holes. All patients who had an open hole after I month had a reopening of the hole after silicone oil removal. Conclusions: Flattening of the retina with resolution of the foveal cysts a fter macular hole repair occurs by the first postoperative day. Closure of the horizontal retinal separation is variable but occurs by the first posto perative month in cases of successful macular hole repair, Persistent retin al separation after 1 month may be predictive of hole reopening.