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Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography.

Hayashi A, Yagou T, Nakamura T, Fujita K, Oka M, Fuchizawa C - Case Rep Ophthalmol (2011)

Bottom Line: The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade.From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

ABSTRACT

Purpose: To examine anatomical changes in idiopathic macular holes during surgery using handheld spectral-domain optical coherence tomography (SD-OCT).

Methods: Five eyes of 5 patients who underwent surgery for the repair of idiopathic macular holes were examined. The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade. Intraoperative SD-OCT images of the macular holes were obtained after ILM removal and under fluid-air exchange using a handheld SD-OCT. From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.

Results: All macular holes were successfully closed after the primary surgery. The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD. In 1 eye with a stage 3 macular hole, SD-OCT images revealed that the inner edges of the macular hole touched each other under fluid-air exchange.

Conclusion: Fluid-air exchange significantly reduced MHBD during surgery to repair macular holes. Fluid-air exchange may be an important step for macular hole closure as it reduces the base diameter of the macular hole.

No MeSH data available.


Related in: MedlinePlus

SD-OCT images of a macular hole from case 1. a Macular hole after ILM removal. b Macular hole under fluid-air exchange. The inner edges of the macular hole touched each other. c Macular hole at 7 postoperative days, showing a bridge formation.
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Figure 1: SD-OCT images of a macular hole from case 1. a Macular hole after ILM removal. b Macular hole under fluid-air exchange. The inner edges of the macular hole touched each other. c Macular hole at 7 postoperative days, showing a bridge formation.

Mentions: The 5 treated eyes of the 5 patients consisted of 2 eyes with a stage 2 macular hole and 3 eyes with a stage 3 macular hole by Gass classification with preoperative SD-OCT. The size of the macular hole was expressed as MHBD [9]. The preoperative and intraoperative MHBD of each eye are shown in table 1. The preoperative MHBD was nearly the same as the intraoperative MHBD after ILM peeling in each eye, but the intraoperative MHBD under fluid-air exchange was smaller than that after ILM peeling in all eyes. The mean preoperative MHBD and intraoperative MHBD after ILM peeling were 678 ± 173 µm (range, 452–815 µm) and 690 ± 155 µm (range, 479–801 µm), respectively. However, the mean MHBD under fluid-air exchange was 484 ± 122 µm (range, 333–608 µm) and significantly smaller than that after ILM peeling (p < 0.05) or before the surgery (p < 0.05). One of the 3 eyes with a stage 3 macular hole (case 1) showed contact of the inner edges of the macular hole under the fluid-air exchange with SD-OCT (fig. 1). The remaining 2 eyes (cases 2 and 3) showed open macular holes under the fluid-air exchange (fig. 2).


Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography.

Hayashi A, Yagou T, Nakamura T, Fujita K, Oka M, Fuchizawa C - Case Rep Ophthalmol (2011)

SD-OCT images of a macular hole from case 1. a Macular hole after ILM removal. b Macular hole under fluid-air exchange. The inner edges of the macular hole touched each other. c Macular hole at 7 postoperative days, showing a bridge formation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3104860&req=5

Figure 1: SD-OCT images of a macular hole from case 1. a Macular hole after ILM removal. b Macular hole under fluid-air exchange. The inner edges of the macular hole touched each other. c Macular hole at 7 postoperative days, showing a bridge formation.
Mentions: The 5 treated eyes of the 5 patients consisted of 2 eyes with a stage 2 macular hole and 3 eyes with a stage 3 macular hole by Gass classification with preoperative SD-OCT. The size of the macular hole was expressed as MHBD [9]. The preoperative and intraoperative MHBD of each eye are shown in table 1. The preoperative MHBD was nearly the same as the intraoperative MHBD after ILM peeling in each eye, but the intraoperative MHBD under fluid-air exchange was smaller than that after ILM peeling in all eyes. The mean preoperative MHBD and intraoperative MHBD after ILM peeling were 678 ± 173 µm (range, 452–815 µm) and 690 ± 155 µm (range, 479–801 µm), respectively. However, the mean MHBD under fluid-air exchange was 484 ± 122 µm (range, 333–608 µm) and significantly smaller than that after ILM peeling (p < 0.05) or before the surgery (p < 0.05). One of the 3 eyes with a stage 3 macular hole (case 1) showed contact of the inner edges of the macular hole under the fluid-air exchange with SD-OCT (fig. 1). The remaining 2 eyes (cases 2 and 3) showed open macular holes under the fluid-air exchange (fig. 2).

Bottom Line: The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade.From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

ABSTRACT

Purpose: To examine anatomical changes in idiopathic macular holes during surgery using handheld spectral-domain optical coherence tomography (SD-OCT).

Methods: Five eyes of 5 patients who underwent surgery for the repair of idiopathic macular holes were examined. The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade. Intraoperative SD-OCT images of the macular holes were obtained after ILM removal and under fluid-air exchange using a handheld SD-OCT. From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.

Results: All macular holes were successfully closed after the primary surgery. The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD. In 1 eye with a stage 3 macular hole, SD-OCT images revealed that the inner edges of the macular hole touched each other under fluid-air exchange.

Conclusion: Fluid-air exchange significantly reduced MHBD during surgery to repair macular holes. Fluid-air exchange may be an important step for macular hole closure as it reduces the base diameter of the macular hole.

No MeSH data available.


Related in: MedlinePlus