Artículo de revista
Outcomes of Outpatient Fluid-Gas Exchange for Open Macular Hole After Vitrectomy
Fecha
2013Registro en:
Am J Ophthalmol 2013;156: 326–333
doi 10.1016/j.ajo.2013.03.031
Autor
Rao, Xi
Wang, Nan Kai
Chen, Yen Po
Hwang, Yih Shiou
Chuang, Lan Hsin
Liu, I Chia
Chen, Kuan Jen
Wu, Wei Chi
Lai, Chi Chun
Institución
Resumen
PURPOSE: To report the efficacy and safety of outpatient
fluid-gas exchange for open macular hole after
primary vitrectomy.
DESIGN: Retrospective interventional case series.
METHODS: SETTING: Institutional. PATIENTS: Thirty-six
patients with primary failed closure or reopened holes
after primary vitrectomy. INTERVENTION: Fluid-gas
excahnge with 15% perfluoropropane (C3F8) or 20%
sulfur hexafluoride (SF6) was performed to reclose the
hole under topical anesthesia. MAIN OUTCOME MEASURES:
The hole closure rate and type, pre- and postexchange
best-corrected visual acuity (BCVA), and complication
rates were assessed.
RESULTS: Thirty-two eyes (89%) achieved anatomic
success from 1-3 weeks after the fluid-gas exchange.
Twenty-two eyes (61%) achieved type 1 closure, 10
eyes (28%) achieved type 2 closure, and 4 eyes (11%)
did not achieve closure. The BCVA for type 1 closure
improved significantly from logarithm of the minimal
angle of resolution (logMAR) 1.66 ± 0.41 to 0.84 ±
0.41, with a P value <.001. The BCVA for type 2
closure improved from logMAR 1.77 ± 0.41 to 1.52 ±
0.41, with a P value of .05. All patients with an unclosed
hole after fluid-gas exchange had a stage IV macular hole
before the primary vitrectomy and a hole size larger than
1000 mm. The complication related to fluid-gas exchange
procedure was transient high intraocular pressure, which
responded well to topical antiglaucoma medications.
There were 2 retinal detachment cases following the
exchange; surgery to reattach the retina was performed,
with visual acuity recovery.
CONCLUSION: Outpatient fluid-gas exchange is an
effective treatment option for eyes with open holes
following vitrectomy.