Office-based intravitreal injection of expansile gas for management of macular hole in previously vitrectomized eyes

Purpose: To report the successful closure of full-thickness macular hole (MH), using an office-based intravitreal gas injection, in two eyes having undergone prior pars plana vitrectomy (PPV). Observations: Patient 1 presented with acute loss of visual acuity to 20/300 in the left eye 5 months follo...

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Bibliographic Details
Main Authors: Michael A. Apolinario, Shaun I.R. Lampen, Tien P. Wong, Christopher R. Henry, Charles C. Wykoff
Format: Article
Language:English
Published: Elsevier 2019-09-01
Series:American Journal of Ophthalmology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993618302135
Description
Summary:Purpose: To report the successful closure of full-thickness macular hole (MH), using an office-based intravitreal gas injection, in two eyes having undergone prior pars plana vitrectomy (PPV). Observations: Patient 1 presented with acute loss of visual acuity to 20/300 in the left eye 5 months following PPV for fovea-off rhegmatogenous retinal detachment; MH was confirmed by examination and optical coherence tomography (OCT). 0.6 cc of 100% C3F8 gas was injected, with subsequent MH closure following one week of face-down positioning. Patient 2 presented with right eye visual acuity of 20/60 one month following PPV for optic nerve pit-associated maculopathy; MH was confirmed by examination and OCT. 0.85 cc of 100% C3F8 gas was injected in the office, with subsequent MH closure following one week of face-down positioning. Conclusions and importance: MH management in previously vitrectomized eyes has traditionally been repeat PPV with internal limiting membrane peeling, fluid-air exchange, and expansile gas exchange. Intravitreal gas injection, in an office-based setting, is a viable clinical approach to close MH in some previously vitrectomized eyes. Keywords: Macular hole, Pars plana vitrectomy, Intravitreal gas injection
ISSN:2451-9936