Reoperation after failed macular hole surgery

William E Smiddy, Raymond N. Sjaarda, Bert M. Glaser, Harry W Flynn, John T. Thompson, Ann Hanham, Robert P. Murphy

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Purpose: The authors determined the anatomic and visual success rates of vitrectomy in patients who have failed previous macular hole surgery. Methods: Standardized Early Treatment Diabetic Retinopathy Study (ETDRS)- style best-corrected visual acuity was measured in each patient pre- and postoperatively. Surgery was performed at two centers using a standardized protocol, as previously reported, using 1330 ng bovine-derived transforming growth factor-beta 2 (TGF-β 2) and 16% perfluoropropane internal gas tamponade. Endpoint analyses were conducted for anatomic closure of the hole, visual improvement of three or more ETDRS lines, and final visual acuity of ≥20/63 and ≥20/40. Results: Forty-eight eyes failing previous macular hole surgery were reoperated. The anatomic results showed closure of the hole in 40 (83%) cases at the end of the mean follow-up interval of 7.4 months. The visual acuity improved in greater than or equal to three lines in 52%, was ≥20/63 in 54%, and was ≥20/40 in 25% of reoperated eyes. The only factor associated with a better final visual acuity was preoperative visual acuity better than 20/80. Nuclear sclerosis leading to cataract extraction was observed in 13 (30%) of 43 initially phakic eyes. Conclusion: Macular hole closure was induced in this subset of reoperated patients. Visual improvement occurred often, although in a lower percentage than has been reported for primary surgical eyes. Repeat vitrectomy should be considered in patients with persistent macular hole after failure of primary surgery.

Original languageEnglish
Pages (from-to)13-18
Number of pages6
JournalRetina
Volume16
Issue number1
StatePublished - Feb 26 1996

Fingerprint

Retinal Perforations
Reoperation
Visual Acuity
perflutren
Vitrectomy
Diabetic Retinopathy
Cataract Extraction
Sclerosis
Transforming Growth Factor beta
Gases
Therapeutics

Keywords

  • macular hole
  • transforming growth factor-beta
  • vitrectomy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Smiddy, W. E., Sjaarda, R. N., Glaser, B. M., Flynn, H. W., Thompson, J. T., Hanham, A., & Murphy, R. P. (1996). Reoperation after failed macular hole surgery. Retina, 16(1), 13-18.

Reoperation after failed macular hole surgery. / Smiddy, William E; Sjaarda, Raymond N.; Glaser, Bert M.; Flynn, Harry W; Thompson, John T.; Hanham, Ann; Murphy, Robert P.

In: Retina, Vol. 16, No. 1, 26.02.1996, p. 13-18.

Research output: Contribution to journalArticle

Smiddy, WE, Sjaarda, RN, Glaser, BM, Flynn, HW, Thompson, JT, Hanham, A & Murphy, RP 1996, 'Reoperation after failed macular hole surgery', Retina, vol. 16, no. 1, pp. 13-18.
Smiddy WE, Sjaarda RN, Glaser BM, Flynn HW, Thompson JT, Hanham A et al. Reoperation after failed macular hole surgery. Retina. 1996 Feb 26;16(1):13-18.
Smiddy, William E ; Sjaarda, Raymond N. ; Glaser, Bert M. ; Flynn, Harry W ; Thompson, John T. ; Hanham, Ann ; Murphy, Robert P. / Reoperation after failed macular hole surgery. In: Retina. 1996 ; Vol. 16, No. 1. pp. 13-18.
@article{f108461813b34a81acbc0586843993ef,
title = "Reoperation after failed macular hole surgery",
abstract = "Purpose: The authors determined the anatomic and visual success rates of vitrectomy in patients who have failed previous macular hole surgery. Methods: Standardized Early Treatment Diabetic Retinopathy Study (ETDRS)- style best-corrected visual acuity was measured in each patient pre- and postoperatively. Surgery was performed at two centers using a standardized protocol, as previously reported, using 1330 ng bovine-derived transforming growth factor-beta 2 (TGF-β 2) and 16{\%} perfluoropropane internal gas tamponade. Endpoint analyses were conducted for anatomic closure of the hole, visual improvement of three or more ETDRS lines, and final visual acuity of ≥20/63 and ≥20/40. Results: Forty-eight eyes failing previous macular hole surgery were reoperated. The anatomic results showed closure of the hole in 40 (83{\%}) cases at the end of the mean follow-up interval of 7.4 months. The visual acuity improved in greater than or equal to three lines in 52{\%}, was ≥20/63 in 54{\%}, and was ≥20/40 in 25{\%} of reoperated eyes. The only factor associated with a better final visual acuity was preoperative visual acuity better than 20/80. Nuclear sclerosis leading to cataract extraction was observed in 13 (30{\%}) of 43 initially phakic eyes. Conclusion: Macular hole closure was induced in this subset of reoperated patients. Visual improvement occurred often, although in a lower percentage than has been reported for primary surgical eyes. Repeat vitrectomy should be considered in patients with persistent macular hole after failure of primary surgery.",
keywords = "macular hole, transforming growth factor-beta, vitrectomy",
author = "Smiddy, {William E} and Sjaarda, {Raymond N.} and Glaser, {Bert M.} and Flynn, {Harry W} and Thompson, {John T.} and Ann Hanham and Murphy, {Robert P.}",
year = "1996",
month = "2",
day = "26",
language = "English",
volume = "16",
pages = "13--18",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Reoperation after failed macular hole surgery

AU - Smiddy, William E

AU - Sjaarda, Raymond N.

AU - Glaser, Bert M.

AU - Flynn, Harry W

AU - Thompson, John T.

AU - Hanham, Ann

AU - Murphy, Robert P.

PY - 1996/2/26

Y1 - 1996/2/26

N2 - Purpose: The authors determined the anatomic and visual success rates of vitrectomy in patients who have failed previous macular hole surgery. Methods: Standardized Early Treatment Diabetic Retinopathy Study (ETDRS)- style best-corrected visual acuity was measured in each patient pre- and postoperatively. Surgery was performed at two centers using a standardized protocol, as previously reported, using 1330 ng bovine-derived transforming growth factor-beta 2 (TGF-β 2) and 16% perfluoropropane internal gas tamponade. Endpoint analyses were conducted for anatomic closure of the hole, visual improvement of three or more ETDRS lines, and final visual acuity of ≥20/63 and ≥20/40. Results: Forty-eight eyes failing previous macular hole surgery were reoperated. The anatomic results showed closure of the hole in 40 (83%) cases at the end of the mean follow-up interval of 7.4 months. The visual acuity improved in greater than or equal to three lines in 52%, was ≥20/63 in 54%, and was ≥20/40 in 25% of reoperated eyes. The only factor associated with a better final visual acuity was preoperative visual acuity better than 20/80. Nuclear sclerosis leading to cataract extraction was observed in 13 (30%) of 43 initially phakic eyes. Conclusion: Macular hole closure was induced in this subset of reoperated patients. Visual improvement occurred often, although in a lower percentage than has been reported for primary surgical eyes. Repeat vitrectomy should be considered in patients with persistent macular hole after failure of primary surgery.

AB - Purpose: The authors determined the anatomic and visual success rates of vitrectomy in patients who have failed previous macular hole surgery. Methods: Standardized Early Treatment Diabetic Retinopathy Study (ETDRS)- style best-corrected visual acuity was measured in each patient pre- and postoperatively. Surgery was performed at two centers using a standardized protocol, as previously reported, using 1330 ng bovine-derived transforming growth factor-beta 2 (TGF-β 2) and 16% perfluoropropane internal gas tamponade. Endpoint analyses were conducted for anatomic closure of the hole, visual improvement of three or more ETDRS lines, and final visual acuity of ≥20/63 and ≥20/40. Results: Forty-eight eyes failing previous macular hole surgery were reoperated. The anatomic results showed closure of the hole in 40 (83%) cases at the end of the mean follow-up interval of 7.4 months. The visual acuity improved in greater than or equal to three lines in 52%, was ≥20/63 in 54%, and was ≥20/40 in 25% of reoperated eyes. The only factor associated with a better final visual acuity was preoperative visual acuity better than 20/80. Nuclear sclerosis leading to cataract extraction was observed in 13 (30%) of 43 initially phakic eyes. Conclusion: Macular hole closure was induced in this subset of reoperated patients. Visual improvement occurred often, although in a lower percentage than has been reported for primary surgical eyes. Repeat vitrectomy should be considered in patients with persistent macular hole after failure of primary surgery.

KW - macular hole

KW - transforming growth factor-beta

KW - vitrectomy

UR - http://www.scopus.com/inward/record.url?scp=0030019683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030019683&partnerID=8YFLogxK

M3 - Article

C2 - 8927804

AN - SCOPUS:0030019683

VL - 16

SP - 13

EP - 18

JO - Retina

JF - Retina

SN - 0275-004X

IS - 1

ER -