Macular hole surgery with microincision vitrectomy surgery and air tamponade

Purpose: To evaluate postoperative outcome for macular hole surgery with 25-guage microincision vitrectomy surgery (MIVS) and air tamponade. Methods. The subjects were 39 eyes of 37 patients, who underwent 25-guage MIVS and air tamponade with mean age of 64.7 years old, gender of 18 men and 19 women, preoperative log MAR vision of 0.62, and followed at least one year. All patients underwent peeling of internal limiting membrane and in some patients underwent simultaneous cataract surgery and creation of posterior vitreous detachment. The closure rate of macular hole, preoperative and postoperative vision were compared. Results: Initial closure rate of macular hole was achieved in 36 of 39 eyes(92%). The 3 eyes of failure after the initial surgery had difficulties of face down positioning. In these 3 eyes, additional 20% SF6 gas was injected intravitreally and macular holes closure was achieved. The postoperative visual improvement (log MAR > 0.2) was seen in 33 eyes(85%). Conclusion: Macular hole closure can be achieved by MIVS and air tamponade. However, longacting gas should be chosen in the patients who have difficulty in maintaining of face down position.