Long-term results regarding healing andcomplications after 25-gauge pars planavitrectomy for large full-thickness macularholes

Abstract: Introduction A full-thickness macular hole (FTMH) is a round deformity in the fovea that involve alllayers of the neurosensory retina. The condition is usually symptomatic and is associatedwith a decreased visual acuity (VA). Large FTMHs are associated to a larger decrease in VA.To treat FTMH pars plana vitrectomy (PPV) is performed to repair the hole. There aredifferent dimensions of instruments in PPV but limited information on the outcome usingeach dimension. Aim This study aims to assess the healing rate of large FTMHs after 25-gauge vitrectomy. Methods The study is a retrospective record review. Patients were identified through the surgicalintervention registry at the Department of Ophthalmology, USÖ. The study included largeFTMHs (diameter > 400 μm) who underwent 25-gauge PPV at USÖ between 2015-2017. Results After 25-gauge PPV 19 (82.6%) out of 23 included eyes healed. No significant difference inhealing rate between subgroups of different sized FTMHs was discovered. Out of 4 eyes thatfailed to heal, 1 patient underwent a reoperation and the other 3 either chose not to or it wasdeemed not indicated. A statistically significant increase in mean VA postoperatively wasobserved. The most reported complications postoperatively were gas cataract and atemporary increase in intraocular pressure. In 7 cases the PPV led to an accelerateddevelopment of cataract and cataract surgery. Conclusion The majority of FTMHs healed after 25-gauge PPV and the mean VA increased after surgery.The most common complications were secondary cataract and temporary increase in IOP.