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Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Adel Galal Zaky,4 Tamer Wasfy,1 Haithem Maamoun Abdelfattah,2,5 Emad Mohamed Elgemai,2,6 Sameh Mohamed El Gouhary,4 Hosam Osman Mansour,7 Hashem Hammouda Ghoraba,1,2 Mohamed Amin Heikal8,9 1Ophthalmology Department, Tanta University, Tanta City, Gharbia, Egypt; 2Ophthalmology Department, Magrabi Eye Hospital, Tanta City, Gharbia, Egypt; 3Retina Department, Research Institute of Ophthalmology, Cairo, Egypt; 4Ophthalmology Department, Menoufia University, Shebein Elkoom City, Menoufia, Egypt; 5Ophthalmology Department, Benha Teaching Hospital, Benha City, Qualuopia, Egypt; 6Ophthalmology Department, Damanhour Teaching Hospital, Dmanhour City, Albehaira, Egypt; 7Alazahr University, Damietta City, Damietta, Egypt; 8Ophthalmology Department, Benha University, Benha City, Qualuopia, Egypt; 9Vitreoretinal Department, Magrabi Eye Hospital, Khober City, Eastern Province, Kingdom of Saudi ArabiaCorrespondence: Mohamed Amin HeikalOphthalmology Department, Benha University, Benha City, Qualuopia, 13511, EgyptTel +00201007131431Email mohammedheikel@gmail.comPurpose: To compare different types of macular holes regarding the anatomic and functional success following pars plana vitrectomy (PPV) and internal limiting membrane (ILM) removal.Methods: A retrospective review of all patients with macular holes treated by PPV, ILM removal with gas tamponade from January 2014 to July 2017 in Magrabi Eye Hospital.Results: One hundred fifty-seven eyes of 153 patients were analyzed. The eyes were classified according to the etiology of macular hole into four groups: 79 eyes with idiopathic macular hole (IMH), 51 eyes with traumatic macular hole (TMH), 16 eyes with macular hole in diabetic patients (DMH) and 11 eyes with myopic macular hole (MMH). We classified the IMH group based on the International Vitreomacular Traction Study Classification according to size into 3 subgroups; subgroup 1: ≤ 250μ, subgroup 2: > 250 to 400μ and subgroup 3: ≥ 400 μ. All types of macular hole showed statistically significant postoperative improvement in BCVA compared to the baseline except cases with MMH. Anatomic postoperative hole closure was achieved in 86.1%, 60.7%, 43.65%, an 45.46% of eyes with IMH, TMH, DMH and MMH, respectively. In eyes with IMH, closure rate in subgroup 1 was significantly higher than in subgroups 2, and 3.Conclusion: PPV, ILM peel and C2F6 technique yielded variable anatomic and functional outcomes in different types of macular holes. Anatomic results were most favorable in IMH and least favorable in MMH. The smaller the diameter of the hole the better the results. The underlying pathogenetic mechanisms that lead to different types of macular holes are pivotal in determining the final outcome.Keywords: ILM peeling, macular holes, pars plana vitrectomy

Hammouda Hamdy Ghoraba,1,2 Hosam Othman Mansour,1,3 Mohamed Ahmed Abdelhafez,1 Sameh Mohamed El Gouhary,4 Adel Galal Zaky,4 Mohamed Amin Heikal,5 Ali Ahmed Ali Ghali3 1Magrabi Eye Hospital, Tanta, Egypt; 2Tanta University, Tanta, Egypt; 3Al Azhar University, Damietta Branch, New Damietta, Egypt; 4Meunofia University, Meunofia, Egypt; 5Benha University, Benha, EgyptCorrespondence: Hosam Othman MansourAl Azhar University, Damietta Branch, New Damietta, EgyptTel +201001559282Email drhmansor@yahoo.comBackground and Objectives: To compare anatomical and visual results of pars plana vitrectomy (PPV) with or without additional encircling band in the management of pediatric traumatic rhegmatogenous retinal detachment (RD) in a tertiary referral center.Methods: A retrospective review of children diagnosed with traumatic rhegmatogenous retinal detachment treated by pars plana vitrectomy with or without encircling band.Results: One hundred thirty-nine eyes of 139 children diagnosed with traumatic rhegmatogenous retinal detachment. Surgeries were performed between May 2011 and November 2016. Patients were followed up for at least 18 months after last intervention. The included eyes were categorized into two groups. Group A (vitrectomy with additional encircling band) included 72 eyes of 72 children; 58 boys and 14 girls. Group B (vitrectomy without encircling band) included 67 eyes of 67 children; 58 boys and 9 girls. In group A, the mean age was 9.21± 3.24. Attached retina was achieved in 61% (44 out of 72 eyes), of which 34 eyes remained attached after silicon oil removal, and 10 eyes remained attached under silicon oil tamponade. Recurrent RD under oil was present in 28 eyes (38.9%). In group B, the mean age was 11.06± 3.64. Attached retina was present in 61.2% (41 out of 67 eyes), of which 30 eyes remained attached after oil removal, and 11 eyes remained attached under silicon oil tamponade. Recurrent RD was present in 26 eyes (38.8%). In group A, the final visual acuity (VA) ranged from NLP to 0.5; 58.7% of patients achieved VA more than counting fingers at 1 meter, and 34.6% of patients achieved VA of 0.05 or more. In group B, the final postoperative VA ranged from NLP to 0.9; 16% of patients achieved VA from counting fingers at 1 meter to 0.05, and 29.2% achieved VA of 0.05 or more.Conclusion: Although no statistically significant difference between the two groups (combined vitrectomy and encircling band versus vitrectomy alone in pediatric traumatic retinal detachment), it is wise to consider adding encircling band in severe trauma cases.Keywords: trauma, pediatric retinal detachment, encircling band, pars plana vitrectomy, silicon oil