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Silicone oil tamponade to seal macular holes without position restrictions
Silicone oil tamponade to seal macular holes without position restrictions
- Source :
- Ophthalmology. 105(11)
- Publication Year :
- 1998
-
Abstract
- Objective The authors performed a study to determine the effectiveness and safety of silicone oil as a substitute for gas to fill the vitreous cavity to treat macular holes. Design Multicenter, nonrandomized, interventional trial. Participants Thirty-seven consecutive patients chose vitrectomy with silicone tamponade instead of gas to treat 40 eyes with stage-2 to stage-4 idiopathic age-related macular holes. Stage-2 holes constituted 40% of the holes, and stage-3 and stage-4 holes made up 60%. Intervention All eyes were treated with vitrectomy, manual detachment of the posterior vitreous face (not done for stage-4 holes), autologous serum instillation, and silicone fill of the vitreous cavity. After insertion of the oil, the patients resumed normal activity with no restriction of head or eye position except to avoid faceup position. The oil was removed after approximately 6 weeks. Main outcome measures The authors considered the seal of the macular hole and the preoperative and postoperative logarithm of the minimum angle of resolution (logMAR) visions the most significant measures for comparison to other studies. Results Eighty percent of all holes and 86% of holes not treated previously were sealed with a single silicone tamponade of the vitreous cavity. The logMAR value of visual acuity improved an average of 0.26 (2.6 lines) to 0.61 (20/81) for all eyes and 0.34 (3.4 lines) to 0.52 (20/66) when the macular hole sealed. Completeness of fill of the vitreous cavity with silicone affected seal of the macular hole. Three of eight eyes in which open holes developed after oil removal had less than 90% fill of the vitreous cavity by silicone. Sixty-nine percent of lenses increased opacity one grade or were removed after silicone tamponade. There were no significant adverse effects arising from silicone tamponade. Conclusions Silicone oil tamponade of macular holes is effective and safe. Silicone may be optimal for the treatment of macular holes in persons who must travel, who cannot maintain facedown positioning, or who have monocular vision. The most important factor in the successful closure of the macular hole was the completeness of fill of the vitreous cavity with silicone oil.
- Subjects :
- Adult
Male
medicine.medical_specialty
Visual acuity
genetic structures
Eye disease
medicine.medical_treatment
Posture
Visual Acuity
Vitrectomy
Pilot Projects
chemistry.chemical_compound
Silicone
Postoperative Complications
Recurrence
medicine
Humans
Silicone Oils
Macular hole
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Middle Aged
medicine.disease
Retinal Perforations
eye diseases
Silicone oil
Surgery
Vitreous Body
Ophthalmology
Treatment Outcome
chemistry
Maculopathy
Female
sense organs
Tamponade
medicine.symptom
Safety
business
Subjects
Details
- ISSN :
- 01616420
- Volume :
- 105
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Ophthalmology
- Accession number :
- edsair.doi.dedup.....10ca56e4b290a76f2f726789094f7886