Anatomic and functional results of vitrectomy and long-term intraocular tamponade for stage 2 macular holes.

Purpose: To investigate the results of pars plana vitrectomy combined with long-term intraocular tamponade in patients with a stage 2 macular hole.

Methods: In a retrospective study, 50 consecutive eyes operated on for stage 2 macular hole were reviewed. The surgical technique included pars plana vitrectomy, separation of the posterior hyaloid, and intraocular tamponade with either 12.5% perfluropropane (C(3)F(8)) gas or silicone oil. Patients treated with C(3)F(8) were instructed to keep face-down positioning for 3 or 4 weeks. Removal of silicone oil took place 4 or 5 weeks after the vitrectomy.

Results: Closure of the macular hole was achieved in all 50 eyes after one operation. The mean postoperative best-corrected distance visual acuity was 20/32 (range, 20/63-20/20), with 49 eyes (98%) having a postoperative visual acuity of 20/50 or better. Visual acuity improved in all eyes postoperatively, with a mean gain of 4.84 +/- 1.95 ETDRS lines.

Conclusion: For stage 2 macular holes, vitrectomy combined with long-term intraocular tamponade can result in a very favorable anatomic and functional outcome that is as good as or better than the results described for other modalities. This approach simplifies the surgical technique, and both adjuvant-related complications and potential retinal damage related to internal limiting membrane peeling or use of indocyanine green are avoided.