Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization
Josh Wallsh, Masumi G Asahi, Ron Gallemore Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron Gallemore 4201 Torrance Blvd Suite 220, Torrance, CA, 90503 Email rongallemoremd@gmail.comPurpose: To evaluate the long-term anatomic and visual outcomes of macular hole (MH)...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/882ee3385a97496e9eb137519d8f8da4 |
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| Sumario: | Josh Wallsh, Masumi G Asahi, Ron Gallemore Retina Macula Institute and Research Center, Torrance, CA, USACorrespondence: Ron Gallemore 4201 Torrance Blvd Suite 220, Torrance, CA, 90503 Email rongallemoremd@gmail.comPurpose: To evaluate the long-term anatomic and visual outcomes of macular hole (MH) repair utilizing triamcinolone acetonide (TA) visualization of the internal limiting membrane (ILM) treated at a tertiary care retina practice.Methods: Retrospective chart review of eyes undergoing MH repair with ILM peel utilizing TA visualization followed by gas tamponade and facedown positioning between 2014 and 2020. Pre- and post-operative visual acuity (VA), IOP, and anatomic closure based on optical coherence tomography were documented.Results: Seventy-eight eyes were followed for 2.3± 0.2 years after primary repair with anatomic closure in 73 (94%) eyes at their final visit and excluding eyes with pathologic myopia, 97%, and for stage 2 and small MHs, 100%. In all eyes, VA significantly improved from 0.97± 0.04 (Snellen: 20/187) to 0.66± 0.06 (20/91) logMAR (p < 0.0001). There were 16 eyes with 4 years of follow-up, 10 (63%) eyes achieving a VA ≥ 20/30 at that follow-up visit. Stage 2 and 3 MHs had significantly greater improvements in VA than Stage 4 MHs, − 0.46 ± 0.06 versus − 0.11 ± 0.11 logMAR (p = 0.021). Of the 13 (17%) eyes with recurrent MHs, 6 (46%) had pathologic myopia and 8 (61.5%) had associated cystoid macular edema. Cataract progression was reported in 52 (96%) phakic eyes and 2 eyes required Ahmed valve placement for management of pre-existing glaucoma.Conclusion: Long-term results of MH repair with TA for ILM visualization demonstrate that it is safe and effective. Visual acuity continued to improve throughout the follow-up. Pre-existing glaucoma may progress and recurrence is associated with pathologic myopia and macular edema.Keywords: macular hole, triamcinolone acetonide, internal limiting membrane |
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