ABSTRACT
PURPOSE: To evaluate the visual and anatomical outcomes of macular hole surgery using phacoemulsification, vitrectomy and intraocular gas tamponade without the use of postoperative face down positioning. METHODS: Phacoemulsification with an intraocular lens implant, followed by vitrectomy with internal limiting membrane peeling and perfluoropropane (C3F8), was performed in patients with stage 3 or 4 macular holes. After surgery, patients had to avoid the supine position for 15 days. Patients with a gas level <50% during the first week had a fluid-gas exchange. Visual acuity and closure of the macular hole were evaluated after 1 year of follow-up. RESULTS: 20 eyes of 20 patients, aged 60 to 75 years (median age 68 years), were included in this study. The best initial visual acuity ranged from 0.05 to 0.13 (ETDRS), with the median being 0.06. The final visual acuity was 0.05 to 0.30 with a median of 0.10. A statistically significant improvement (p=0.001, Wilcoxon) was found. The anatomic postoperative results revealed 90% (n=18) of the macular holes were closed while 10% (n=2) were not. CONCLUSIONS: Macular hole surgery has, in general, good results and patients can achieve improvement in their visual acuity without the need for uncomfortable and unbearable post operative posture positions.
Subject(s)
Phacoemulsification , Retinal Perforations/surgery , Vitrectomy , Aged , Data Interpretation, Statistical , Female , Follow-Up Studies , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Postoperative Care , Posture , Time Factors , Visual AcuityABSTRACT
Objetivos: Evaluar los resultados visuales y anatómicosen el tratamiento del agujero macular confacoemulsificación, vitrectomía y gas intraocularsin mantenimiento de posición boca abajo en elpostoperatorio.Material y metodos: Se realizó cirugía de facoemulsificacióncon implante de lente intraocular,vitrectomía con pelado de la membrana limitanteinterna y gas perfluoropropano (C3F8) al 17% enpacientes con diagnóstico de agujero macular gradosIII y IV. En el postoperatorio se indicó evitar laposición supina durante 15 días. Se realizó intercambioliquido gas en los pacientes con menos del50% de gas a la primera semana. Se evaluó la mejoríade la agudeza visual y el porcentaje de cierre delagujero macular después de un año de seguimiento.Resultados: Se incluyeron 20 ojos de 20 pacientescon edad entre 60 y 75 años con una mediana de 68años. La mejor agudeza visual corregida (AVcc)inicial varió de 0,05 a 0,13 con una mediana de0,06. La AVcc final estuvo entre 0,05 a 0,3 con una clasificamedianade 0,10. Al comparar la agudeza visual inicialy final se encontró una mejoría estadísticamentesignificativa de p=0.001(Wilcoxon). Los resultadospostoperatorios en cuanto al estado anatómicofinal del agujero macular fueron exitosos en el 90%(n= 18) y sin éxito en el 10% (n=2).Conclusiones: La cirugía de agujero macular esgeneralmente beneficiosa y los pacientes puedenmejorar su visión sin ser necesario el mantenimientode posiciones incomodas e intolerables paraalgunos pacientes
Purpose: To evaluate the visual and anatomical outcomes of macular hole surgery using phacoemulsification, vitrectomy and intraocular gas tamponade without the use of postoperative face down positioning. Methods: Phacoemulsification with an intraocular lens implant, followed by vitrectomy with internal limiting membrane peeling and perfluoropropane (C3F8), was performed in patients with stage 3 or 4 macular holes. After surgery, patients had to avoid the supine position for 15 days. Patients with a gas level <50% during the first week had a fluid-gas exchange. Visual acuity and closure of the macular hole were evaluated after 1 year of follow-up. Results: 20 eyes of 20 patients, aged 60 to 75 years (median age 68 years), were included in this study. The best initial visual acuity ranged from 0.05 to 0.13 (ETDRS), with the median being 0.06. The final visual acuity was 0.05 to 0.30 with a median of 0.10. A statistically significant improvement (p=0.001, Wilcoxon) was found. The anatomic postoperative results revealed 90% (n=18) of the macular holes were closed while 10% (n=2) were not. Conclusions: Macular hole surgery has, in general, good results and patients can achieve improvement in their visual acuity without the need for uncomfortable and unbearable post operative posture positions
