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 Table of Contents  
JOURNAL REVIEW
Year : 2017  |  Volume : 29  |  Issue : 2  |  Page : 144-145

Macular hole surgery revisited: Effect of tamponading agents and different size of internal limiting membrane peeling on anatomical and functional outcomes


Vitreo-retina Department, Giridhar Eye Institute, Cochin, Kerala, India

Date of Web Publication10-Aug-2017

Correspondence Address:
Rutul R Patel
Vitreo-retina Department, Giridhar Eye Institute, Cochin, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_81_17

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How to cite this article:
Patel RR, Gopalakrishnan M. Macular hole surgery revisited: Effect of tamponading agents and different size of internal limiting membrane peeling on anatomical and functional outcomes. Kerala J Ophthalmol 2017;29:144-5

How to cite this URL:
Patel RR, Gopalakrishnan M. Macular hole surgery revisited: Effect of tamponading agents and different size of internal limiting membrane peeling on anatomical and functional outcomes. Kerala J Ophthalmol [serial online] 2017 [cited 2019 Jun 25];29:144-5. Available from: http://www.kjophthal.com/text.asp?2017/29/2/144/212764




  Sulfurhexafluoride Versus Perfluoropropane Gas as Tamponade in Macular Hole Surgery Top


Modi A, Giridhar A, Gopalakrishnan M. Retina. 2017 Feb; 37:283-90.

It is a retrospective comparative cohort study to compare the outcomes of macular hole surgery using sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) gas. There was no significant difference in macular hole closure rate in both the groups irrespective of macular hole size, stage, or duration. There was a significant increase in intraocular pressure in C3F8 group compared to SF6 group (P < 0.05). Cataract progression was also more in C3F8 group compared to SF6 group (P = 0.20). Thus, the effects of SF6 gas are comparable to those of C3F8, with lesser incidences of cataract and glaucoma. Hence, SF6 can be considered as a preferable tamponading agent in primary surgery, while C3F8 can be used in cases of resurgery for persistent macular hole.


  Comparative Analysis of Outcomes With Variable Diameter Internal Limiting Membrane Peeling in Surgery for Idiopathic Macular Hole Repair Top


Modi A, Giridhar A, Gopalakrishnan M. Retina. 2017; 37:265-73.

It is a prospective comparative cohort study for comparing the outcome with variable (3 mm and 5 mm) diameters of internal limiting membrane (ILM) peeling in the surgery of idiopathic macular hole. No difference was noted in anatomical success rate, irrespective of size, stage, and duration of hole in both the groups. Significant visual improvement was noted in eyes with 3 mm group compared to 5 mm group (P = 0.04). Significant retinal nerve fiber layer thinning was noted 2.5 mm temporal to fovea in follow-up optical coherence tomography (OCT) scan of patients with 5 mm peel (P < 0.05). Hence, increasing the diameter of ILM peel demonstrated no additive advantage, anatomically or functionally; therefore, it is imperative to remove ILM around the edge of the hole rather than increasing the size of peel.


  Spectral Domain-Optical Coherence Tomography-Based Microstructural Analysis of Retinal Architecture Postinternal Limiting Membrane Peeling for Idiopathic Macular Hole Repair Top


Modi A, Giridhar A, Gopalakrishnan M. Retina. 2017 Feb; 37:291-8.

It is a prospective, interventional study of spectral domain-OCT (SD-OCT)-based analysis of retinal architecture after ILM peeling. Layer-by-layer analysis medial to fovea showed significant increase in overall thickness of retina with maximum contribution from increase in thickness of inner nuclear and inner plexiform layer (IPL) while temporally, significant reduction in retinal thickness was observed, with maximum thinning observed in ganglion cell and IPLs. Ganglion cell layer was the only layer which demonstrated thinning on both sides of fovea. Hence, there are significant alterations in cellular architecture of retina post-ILM peeling for macular hole surgery. Ganglion cells sustains maximum damage which can alter the functional outcome of macular hole.


  “vacuole” Sign Adjacent to Retinal Pigment Epithelial Defects on Spectral Domain-Optical Coherence Tomography in Central Serous Chorioretinopathy Associated With Subretinal Fibrin Top


Rajesh B, Kaur A, Giridhar A, Gopalakrishnan M. etina. 2017 Feb; 37:316-24.

It is a retrospective observational case series of patients with central serous chorioretinopathy (CSCR) with subretinal fibrin assessed with SD-OCT and fundus fluorescence angiography (FFA). A hyporeflective oval-shaped vacuole-like area of clearing was observed (vacuole sign) in all patients overlying the area of the RPE defects corresponding to point leak in FFA. Hence, patients with subretinal fibrin provide contrast due to hyper-reflectivity in OCT, and the site of clear fluid egress becomes apparent as hyporeflective vacuole. It can be useful in patients where FFA is contraindicated to predict the site of point leak in CSCR.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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