INTRAVITREAL INJECTION OF AIR FOR THE TREATMENT OF VITREOMACULAR TRACTION.

PURPOSE: To study the efficacy of a single intravitreal injection of air as a valuable alternative to current treatment options (conservative, pharmacological, and surgical) in patients with symptomatic, focal vitreomacular traction. METHODS: Interventional, nonrandomized clinical study including a consecutive series of patients who underwent a single injection of 0.3 mL of air for vitreomacular traction. Each patient underwent best-corrected visual acuity, and spectral domain optical coherence tomography before and after the procedure. Mean maximal horizontal vitreomacular adhesion and a maximal foveal thickness were measured manually. RESULTS: Four eyes of four patients, all males, were included in the study. Mean age was 71 ± 6.7 years; mean best-corrected visual acuity was 0.3 ± 0.08 logarithm of the minimum angle of resolution (logMAR) (20/40 Snellen equivalent). One month following treatment, complete resolution of vitreomacular traction was achieved in 100% of eyes. Mean visual acuity postinjection was 0.18 ± 0.09 logMAR (20/32 Snellen equivalent) (Student's t test for repeated measures P = 0.03). No correlation has been found between horizontal vitreomacular adhesion and best-corrected visual acuity or maximal foveal thickness and best-corrected visual acuity (P = 0.7 and P = 0.9, respectively). CONCLUSION: Intravitreal injection of air could offer a minimally invasive, low-cost alternative treatment in patients with symptomatic, persisting vitreomacular traction. Additional studies on a larger number of patients are required.

Pilot Evaluation of a New Surgical Technique for Persistent or Recurrent Large Macular Holes.

BACKGROUND AND OBJECTIVE: To describe a new surgical technique for persistent or recurrent large macular holes (MHs). PATIENTS AND METHODS: Patients with recurrent or persistent large MHs following vitrectomy with internal limiting membrane (ILM) peeling were recruited between October and September 2017 in this pilot study. All patients underwent preoperative and postoperative best-corrected visual acuity (BCVA), slit-lamp ophthalmoscopy, and spectral-domain optical coherence tomography (SD-OCT). This new technique consisted in autologous ILM patch transplantation on top of MH under perfluorocarbon liquid (PFCL) bubble, using SF6 as tamponade. The patients maintained a prone position for 3 days. RESULTS: Five eyes of five consecutive patients (two males, three females; mean age: 67.4 years) with recurrent (one patient) or persistent (four patients) MHs were successfully treated. At 1-month follow-up, mean BCVA increased from approximately 20/400 to approximately 20/63, and MHs were closed in all cases. Mean follow-up was 5 months ± 2.2 months (6 months for four out of five included eyes). Positive outcomes were consistent at last follow-up. CONCLUSION: This new technique consisting of autologous ILM patch transplantation on top of MH under PFCL bubble using SF6 as tamponade may represent a validated surgical option for persistent or recurrent large MHs. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:266-268.].