Comparison of Surgical Results for Idiopathic Macular Hole: Fluid-Gas Exchange vs. Fluid-Air Exchange

ABSTRACT

PURPOSE: In pars plana vitrectomy for macular hole, internal limiting membrane (ILM) peeling, fluid-gas exchange, prone position for more than one week are generally needed. However, the authors modified these surgical procedures. After vitrectomy, we performed ILM peeling with Indocyanine green (ICG) dye and fluid air exchange and kept the patient prone position for one day. We then compare the clinical results and analyze possible factors affecting surgical outcomes. METHODS: Data were reviewed from a retrospective study on Group I, form whom vitrectomy, fluid gas exchange, and ILM peeling without ICG were completed, and on Group II, for whom vitrectomy, fluid air exchange, and ILM peeling with ICG were completed. We evaluated the anatomical and functional success statistically. RESULTS: The anatomical success rate was 79% and 94% and the functional success rate was 42% and 88% in groups I and II respectively. Furthermore, preoperative visual acuity significantly affected the visual outcome. CONCLUSIONS: Without having to maintainl face-down position for a long time, successful anatomical and functional outcomes were obtained through fluid air exchange and prone position for one day. This result suggests that complete ILM peeling with ICG shortens the required duration of tamponade and allows for less stringent maintenance of face-down position.