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Macular Hole
A Continuing Saga
Arch Ophthalmol. 1999;117:248-249.
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IT HAS BEEN FASCINATING to observe how clinical interest in the subject of macular holes has evolved during this decade. Prior to 1991, it would have been unthinkable that there would be a section on macular hole and macular hole surgery on the program of virtually every national and international meeting of vitreoretinal surgeons. The 3 driving forces underlying this metamorphosis are the development of new ideas concerning pathogenesis, the availability of treatment, and the emergence of new data on prevalence.
The first advance was the Gass1 concept of pathogenesis. It involved progressive tangential traction from adherent, posterior, cortical vitreous that leads to foveal elevation and eventually to hole formation. The second breakthrough was the observation by Kelly and Wendel2 that vitreous surgery followed by internal tamponade could close a macular hole and lead to improved visual acuity in some patients. The third major contribution was the report by Rahmani . . . [Full Text of this Article]
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Arch Ophthalmol. 1999;117(2):242-246.
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