Pars Plana Vitrectomy and Intraocular Gas Tamponade for the Treatment of Retinal Detachment with Macular Hole

Suh, Sung Gug; Hahn, Young Ho; Kim, Shin Dong

Abstract

Twelve eyeys of retinal detachment with full thickness macular hole without(Group 1:6 eyes) and with(Group II:6 eyes) peripheral retinal tears were treated by pars plana vitrectomy and partial or full fluid gas exchange at our hospital from 1987 to 1990. Five showed high myopia, four had trauma histories and in the remammg three were of unknown cause. Other procedures included were; internal drainage of subretinal fluid through macular hole(6 eyes), transscleral drainage(one eye), membrane peeling(one eye), encirclement(7 eyes) and segmental buckle(6 eyes) for peripheral retinal tears and silicone oil injection(one eye). No direct attempts to seal macular hole using photocoagulation or posterior pole buckles were made. During the follow-up period ranging from 6 to 25 months, retinal reattachments were achieved in eleven eyes(92%) and visual acuities improved in seven eyes(58%), were unchanged in three(25%), worsened in two(17%). The causes of worse vision included a redetachment and a macular slantng by high buckle for the tears elsewhere posterior to equator. Among several causative factors, a method releaving the vitreal traction component and a temporary internal tamponade with gas is thought to be the best way to treat this disease.