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Article: Is It Worth Reoperating on Macular Holes?

TitleIs It Worth Reoperating on Macular Holes?
Authors
Issue Date2008
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophtha
Citation
Ophthalmology, 2008, v. 115 n. 1, p. 158-163 How to Cite?
AbstractObjective: To evaluate the visual outcome after a second surgical attempt to close idiopathic full-thickness macular holes (FTMH) in patients who underwent unsuccessful primary surgery and in patients with reopened FTMHs. Design: Retrospective single-center case series. Participants: Five hundred thirty-two patients underwent surgery for FTMH in St. Paul's Eye Unit, Liverpool, United Kingdom, between March, 1995, and March, 2005. Fifty-one patients had unclosed FTMHs (unclosed group) and 21 patients had reopened FTMHs after initially successful surgery (reopened group). Methods: All patients underwent a second pars plana vitrectomy. Autologous platelet concentrate and perfluoropropane endotamponade were used. Internal limiting membrane peeling was carried out in selected cases. Patients were instructed to maintain a face-down position for 2 weeks after the surgery. Main Outcome Measures: Anatomic and visual results. Results: All patients in the reopened group and 76% of patients in the unclosed group achieved successfully closure of the FTMH after the second surgery. Mean decimal Snellen visual acuity (VA; ±standard deviation [SD]) before the second surgery was 0.14±0.10 (range, 0.01-0.33) in the reopened group and 0.10±0.07 (range, hand movements [HM]-0.33) in the unclosed group. The best VA was achieved after cataract surgery; the mean best VA (±SD) in the reopened group was 0.42±0.31 (range, 0.05-1) and in the unclosed group was 0.19±0.14 (range, HM-0.66). Conclusions: Reoperating on reopened FTMH resulted in 100% anatomic closure and significant improvement in vision. In contrast, reoperating on patients with initially unsuccessful surgery resulted a lower anatomic closure rate and relatively poor final vision even if their macular holes were closed successfully. This information may help surgeons and patients decide whether to undertake a second operation. © 2008 American Academy of Ophthalmology.
Persistent Identifierhttp://hdl.handle.net/10722/146298
ISSN
2015 Impact Factor: 6.75
2015 SCImago Journal Rankings: 4.745
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorValldeperas, Xen_HK
dc.contributor.authorWong, Den_HK
dc.date.accessioned2012-04-10T01:50:02Z-
dc.date.available2012-04-10T01:50:02Z-
dc.date.issued2008en_HK
dc.identifier.citationOphthalmology, 2008, v. 115 n. 1, p. 158-163en_HK
dc.identifier.issn0161-6420en_HK
dc.identifier.urihttp://hdl.handle.net/10722/146298-
dc.description.abstractObjective: To evaluate the visual outcome after a second surgical attempt to close idiopathic full-thickness macular holes (FTMH) in patients who underwent unsuccessful primary surgery and in patients with reopened FTMHs. Design: Retrospective single-center case series. Participants: Five hundred thirty-two patients underwent surgery for FTMH in St. Paul's Eye Unit, Liverpool, United Kingdom, between March, 1995, and March, 2005. Fifty-one patients had unclosed FTMHs (unclosed group) and 21 patients had reopened FTMHs after initially successful surgery (reopened group). Methods: All patients underwent a second pars plana vitrectomy. Autologous platelet concentrate and perfluoropropane endotamponade were used. Internal limiting membrane peeling was carried out in selected cases. Patients were instructed to maintain a face-down position for 2 weeks after the surgery. Main Outcome Measures: Anatomic and visual results. Results: All patients in the reopened group and 76% of patients in the unclosed group achieved successfully closure of the FTMH after the second surgery. Mean decimal Snellen visual acuity (VA; ±standard deviation [SD]) before the second surgery was 0.14±0.10 (range, 0.01-0.33) in the reopened group and 0.10±0.07 (range, hand movements [HM]-0.33) in the unclosed group. The best VA was achieved after cataract surgery; the mean best VA (±SD) in the reopened group was 0.42±0.31 (range, 0.05-1) and in the unclosed group was 0.19±0.14 (range, HM-0.66). Conclusions: Reoperating on reopened FTMH resulted in 100% anatomic closure and significant improvement in vision. In contrast, reoperating on patients with initially unsuccessful surgery resulted a lower anatomic closure rate and relatively poor final vision even if their macular holes were closed successfully. This information may help surgeons and patients decide whether to undertake a second operation. © 2008 American Academy of Ophthalmology.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophthaen_HK
dc.relation.ispartofOphthalmologyen_HK
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBlood Plateletsen_US
dc.subject.meshDecision Makingen_US
dc.subject.meshFemaleen_US
dc.subject.meshFluorocarbons - Administration & Dosageen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRecurrenceen_US
dc.subject.meshReoperationen_US
dc.subject.meshRetinal Perforations - Physiopathology - Surgeryen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshVisual Acuity - Physiologyen_US
dc.subject.meshVitrectomyen_US
dc.titleIs It Worth Reoperating on Macular Holes?en_HK
dc.typeArticleen_HK
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.ophtha.2007.01.039en_HK
dc.identifier.pmid17512597-
dc.identifier.scopuseid_2-s2.0-37449001443en_HK
dc.identifier.hkuros167150-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-37449001443&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume115en_HK
dc.identifier.issue1en_HK
dc.identifier.spage158en_HK
dc.identifier.epage163en_HK
dc.identifier.eissn1549-4713-
dc.identifier.isiWOS:000252137300023-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridValldeperas, X=14018791900en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK

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