Vitrectomy for laser-induced full-thickness macular hole

BMC Ophthalmology

Rui Jiang¹  Xin Wang¹  Ting Zhang¹  Gezhi Xu² 

[1] Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, 200031, Shanghai, China;Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, 200031, Shanghai, China;NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, 200031, Shanghai, China;Shanghai Key Laboratory of Visual Impairment and Restoration, 200031, Shanghai, China;

关键词: Laser injury;    Macular hole;    Vitrectomy;    Optical coherence tomography;    Optical coherence tomography angiography;   

DOI  :  10.1186/s12886-021-01893-8

来源: Springer

【 摘 要 】

BackgroundTo report the structure and visual outcomes of pars plana vitrectomy (PPV) for laser-induced full-thickness macular holes (MHs).MethodsThis retrospective study enrolled 10 patients who underwent vitrectomy for MHs caused by laser injury. Best corrected visual acuity (BCVA), macular spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA) were used for assessment.ResultsFour patients were injured by unexpected expose of an yttrium aluminum garnet (YAG) laser, and six patients were accidentally injured by a handheld laser. The MH minimum diameters (MDs) ranged from 55 to 966 μm (mean = 548.00 ± 286.10 μm), and BCVA ranged from 20/400 to 20/50 (mean = logMAR 0.87 ± 0.29) preoperatively. All 10 eyes underwent PPV, internal limiting membrane (ILM) peeling, and gas tamponade. All eyes demonstrated closure of the MH with different degrees of discontinuity of the outer layer of the retina, and four eyes exhibited serious retinal pigment epithelium (RPE) destruction. Postoperative BCVA values were significantly improved (mean = logMAR 0.55 ± 0.33; P = 0.032, t = 2.234). The mean BCVA of the destroyed RPE group was significantly worse than that of the non-destroyed RPE group both before and after surgery (P = 0.019; Wilcoxon signed rank test). Further, OCTA indicated choroidal ischemia in the laser-induced MHs.ConclusionVitrectomy can be successful in closing laser-induced full-thickness MHs and improving visual acuity. However, If RPE/choroid is involved in laser damage in addition to the outer retinal layer, this may indicate poor visual prognosis.

【 授权许可】

CC BY