Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor beta 2.
Affiliation
Department of Ophthalmology, Cork University Hospital, Wilton, Ireland.Issue Date
2012-02-03T15:14:46ZMeSH
AdultAged
Aged, 80 and over
Blood Transfusion, Autologous
Combined Modality Therapy
Female
Gases/*therapeutic use
Humans
Male
Middle Aged
*Platelet Transfusion
Postoperative Period
Prospective Studies
Retinal Perforations/surgery/*therapy
Transforming Growth Factor beta/*therapeutic use
Visual Acuity
*Vitrectomy
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Show full item recordCitation
Br J Ophthalmol. 1997 Dec;81(12):1073-9.Journal
The British journal of ophthalmologyPubMed ID
9497468Abstract
BACKGROUND: Vitrectomy and gas tamponade has become a recognised technique for the treatment of macular holes. In an attempt to improve the anatomic and visual success of the procedure, various adjunctive therapies--cytokines, serum, and platelets--have been employed. A consecutive series of 85 eyes which underwent macular hole surgery using gas tamponade alone, or gas tamponade with either the cytokine transforming growth factor beta 2 (TGF-beta 2) or autologous platelet concentrate is reported. METHODS: Twenty eyes had vitrectomy and 20% SF6 gas tamponade; 15 had vitrectomy, 20% SF6 gas, and TGF-beta 2; 50 had vitrectomy, 16% C3F8 gas tamponade, and 0.1 ml of autologous platelet concentrate prepared during the procedure. RESULTS: Anatomic success occurred in 86% of eyes, with 96% of the platelet treated group achieving closure of the macular hole. Visual acuity improved by two lines or more in 65% of the SF6 only group, 33% of those treated with TGF-beta 2 and in 74% of the platelet treated group. In the platelet treated group 40% achieved 6/12 or better and 62% achieved 6/18 or better. The best visual results were obtained in stage 2 holes. CONCLUSION: Vitrectomy for macular holes is often of benefit and patients may recover good visual acuity, especially early in the disease process. The procedure has a number of serious complications, and the postoperative posturing requirement is difficult. Patients need to be informed of such concerns before surgery.Language
engISSN
0007-1161 (Print)0007-1161 (Linking)
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