Treatment of Failed Macular Hole after Vitrectomy by Outpatient Gas Injection and Laser Photocoagulation

ABSTRACT

PURPOSE: This study aimed to assess the effect of gas injection and laser photocoagulation for patients with opened macular holes who had previously undergone trans pars plana vitrectomy. METHODS: A retrospective study for 6 patients (6 eyes) who had opened macular holes after vitrectomy were treated by an outpatient method consisting of laser photocoagulation to the foveal pigment epithelium followed by injection of 100% SF6 gas. Visual acuity, anatomic status of the macular hole, and complications were evaluated. RESULTS: The length of period of gas injection and laser photocoagulation was distributed to 1 month to 8months (mean 3.2 months) and follow up period was distributed to 8 months to 25 months (mean 14.3months). Three of six eyes with gas injection and laser photocoagulation achieved anatomic success and two of them achieved visual improvement by more than two lines. Three eyes among four phakic eyes developed nucleosclerosis of the lens and one eye developed transient elevation of intraocular pressure. CONCLUSIONS: The outpatient gas injection and laser photocoagulation appears to be a safe and cost-effective alternative to repeated surgery for opened macular holes after trans pars plana vitrectomy.