A simplified method of treating retinal detachment with macular hole. Long-term follow-up
Y. Miyake
Eighteen patients with macular hole retinal detachment and no visible
posterior vitreoretinal connections were treated by one of two methods. In
ten patients with extensive retinal detachment, the subretinal fluid was
released in the temporal scleral side, and 1.0 mL or more of air or gas was
injected into the vitreous cavity through the pars plana. In eight patients
with localized retinal detachment in the posterior pole, 0.7 mL or more of
gas was injected into the vitreous cavity after 0.3 to 0.5 mL of aqueous
humor was released. Macular buckling, macular diathermy, or vitrectomy was
not used. After the operation, the patients were placed in a prone position
for at least six hours a day until the air or gas disappeared from the
vitreous cavity. In 15 of 18 patients, the retina remained attached during
follow-up periods that ranged from four to 32 months (average, 14 months).
This operation is easy and safe and requires no sophisticated instruments.
In addition, the macula is not damaged, as it can be by diathermy and
buckling. This procedure should be the treatment of choice in patients with
retinal detachments with macular holes but without other breaks or visible
vitreous adhesion.
