Purpose:

To evaluate the effectiveness and safety of 25-Gauge (G) transconjunctival sutureless vitrectomy (TSV) in the treatment of idiopathic macular hole.

Material and Method:

In this retrospective study, we evaluated 13 eyes of 13 consecutive patients, who underwent 25-G TSV for idiopathic macular hole between April 2004 and December 2006 in our institution. Main outcome measures were anatomical and functional outcomes, as well as intraoperative and postoperative complications. Paired samples t-test was used for statistical analysis.

Results:

The mean follow-up time was 6.7±6.3 (range, 3-26) months. Macular hole was closed with a single operation in 12 eyes (92.3%). The patient whose macular hole remained open refused another surgery. The mean logMAR visual acuity was 1.2±0.12 preoperatively and 0.82±0.58 postoperatively (p=0.007, Paired t-test). Visual acuity improved in all eyes, except for the patient whose macular hole remained open. Postoperative visual acuity improved 2 or more lines in 4 (30.7%) eyes and was better than 0.5 in 2 (15.4%) eyes. No severe complication was observed intraoperatively. No sutures were required to close the scleral or conjunctival openings, and no eyes required conversion of surgery to 20-G pars plana vitrectomy. Postoperative complications were transient increase of intraocular pressure in 1 eye (7%) and cataract progression in 3 of 9 phakic eyes (33.3%).

Discussion:

25-gauge TSV system appears to be an effective and safe procedure in the treatment of idiopathic macular hole. Further studies with a large number of patients and long follow-up are required. (TOD Journal 2010; 40: 135-9)

Keywords: Idiopathic macular hole, pars plana vitrectomy, transconjunctival sutureless vitrectomy, 25-gauge vitrectomy