Hydraulic centripetal retinal displacement

Efficiency of the Retinal Displacement Technique in the Treatment of Traumatic Full Thickness Macular Holes

Methods:

This study is a retrospective consecutive case series of 7 patients who underwent a 25G PPV with the displacement of macular retina after subretinal balanced salt solution injection to treat traumatic full thickness macular holes (TFMH). The efficiency was evaluated by the anatomical macular hole closure rate and best-corrected visual acuity (BCVA) during follow-up visits. The degree of retinal displacement was accessed by comparing the preoperative and postoperative fundus photographies.

Results:

Anatomical complete closure of macular hole was achieved in 6 of 7 eyes (85,7%) and 1 of 7 eyes (14,3%) had partial closure (flat/open) with decrease of macular hole size over a minimum follow-up period of 6 months. Average macular hole diameter was (825±150 μm) (range: 676–1130). Values of visual acuity after surgery in the total group was significantly increased (t = 4,45; p = 0.004). Subgroup analysis of the patients with successful holes closure revealed a statistically significant improvement in visual acuity (t = 5,53; p = 0.003). All patients revealed a negative correlation (r = 0,76; p = 0,05) between postoperative visual acuity and the time elapsed from the moment of the trauma, and a strong positive correlation (r = 0,94, p = 0,002) between the macular hole size and elapsed time from the injury. Dependence of postoperative visual acuity from the macular hole size has not reached the level of statistical significance (r = 0,69; p = 0,09). There were no intra operative or postoperative complications.

Conclusion:

Vitrectomy with the hydraulic centripetal retinal displacement technique may be an effective addition to surgical options for treating traumatic full thickness macular holes.