Macular Hole Repair Using Heavy Silicone Oil Tamponade Can Achieve Success

Heavily silicone oil (HSO) tamponade is a safe and effective surgical approach for treating persistent full-thickness macular holes (FTMH), according to a study published in Retina. Better best corrected visual acuity (BCVA) and shorter minimum linear diameter (MLD) before surgery may serve as indicators for achieving anatomical success, according to the report. 

The retrospective single-center study included 63 eyes from 62 patients (mean age: 68.3±9.2 years, age range: 38-81 years, 47 women, 15 men) with persistent FTMH undergoing HSO tamponade following primary vitreoretinal surgery. The mean follow-up was 18.7±22.5 months (range: 1-112 months). During follow-up, macular spectral-domain optical coherence tomography (SD-OCT) and BCVA measurements were performed. 

The researchers found that 50 of 63 eyes (79.4%) achieved anatomical success. Among eyes achieving anatomical success, BCVA before primary vitreoretinal surgery was significantly better (0.77 [∼20/125 Snellen] ±0.24 [1.3-0.3] logMAR) compared with eyes not achieving anatomical success (0.88 [∼20/160 Snellen] ±0.17 (1.1-0.6) logMAR, P =.044). MLD of FTMH was significantly shorter in eyes achieving anatomical success, both before primary (403.4±128.7 [199.0-707.0] µm vs 568.1±209.1 [307.0-953.0] µm, P =.009) as well as secondary surgery (464.1±215.0 [178.0-1521.0] µm vs 663.3±228.5 [451.0-1301.0] µm, P =.010).

Among patients remaining phakic during all 3 surgeries, BCVA improvement was not observed, although anatomical success was achieved, according to the study.  

“This study contains the largest group of eyes affected by FTMH treated with HSO tamponade to date,” according to the researchers. “In conclusion, HSO tamponade in secondary surgery for persistent FTMH is a safe and efficient surgical method with no need for additional adjuvants or surgical maneuvers. Better BCVA and smaller MLD may prior to surgery may be indicators for anatomical success”

Study limitations include the retrospective design and the number of patients who received Densiron 68 compared with Oxane-HD were not equal.