Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.

ABSTRACT

A 65‑year‑old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full‑thickness macular hole in left eye; confirmed by optical coherence tomography (OCT). Patient underwent phacoemulsification with intraocular lens (IOL) implantation, vitrectomy, internal limiting membrane (ILM) peeling and 14% C3F8 gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid–gas exchange with 14% C3F8 gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re‑surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re‑surgery than those without. However, larger studies with longer follow‑up are required to validate this finding.