Use of heavy silicone oil (Densiron-68) in the treatment of persistent macular holes.

Purpose: In this retrospective case series, we studied the effect of 'heavy' silicone oil on persisting macular holes. Patients with macular holes that failed to close after conventional macular hole surgery were retreated with the longterm internal tamponade Densiron-68.

Methods: Twelve patients with primary macular holes that persisted after pars plana vitrectomy, peeling of the internal limiting membrane and internal gas tamponade with SF6 (sulphur hexafluoride) were retreated with heavy silicone oil, Densiron-68, in the University Eye Hospital, Cologne. After 1.5-4 months the Densiron-68 was removed. Best corrected visual acuity (VA), slit-lamp examination, binocular fundus examination and optical coherence tomography (OCT) were used for evaluation pre- and postoperatively. The follow-up period was 3-7 months.

Results: Preoperatively, all patients displayed full-thickness macular holes, with a mean size of 502.25 microm (+/- 129.39 microm). Postoperatively, 11 of 12 macular holes were closed. One patient experienced a reopening of the macular hole. Mean VA was 20/250 (1.07 +/- 0.22 logMAR) prior to treatment with Densiron-68 and 20/160 (0.84 +/- 0.24 logMAR) postoperatively. Visual acuity increased from baseline in nine patients and decreased in one.

Conclusions: Retreatment of persisting macular holes with the heavy, longterm tamponade Densiron-68 resulted in anatomical closure of the hole in 11 of 12 cases. This result was accompanied by a functional improvement in VA in nine of 12 patients.