1Staudt S., 2Unnebrink K., 1Jorzig J., 1Holz F. G.

1Universitäts-Augenklinik Heidelberg, INF 400, 2Koordinierungszentrum für Klinische Studien Heidelberg, INF 305, 69120 Heidelberg

Purpose: Air/gas-tamponade is commonly used in macular hole surgery. However, postoperative positioning is impossible for some patients. We evaluated silicone oil without postoperative positioning in comparison to air/gas-tamponade with regard to anatomic hole closure, visual outcome, and postoperative angiographic findings.
Methods: Between 10/1997 and 04/2001 macular hole surgery was performed in 129 eyes of 120 patients by one surgeon (FGH). In 24 eyes silicon oil (5000 cs.) was used as tamponade. 16 % C2F6 was applied in eyes with gas tamponade. Serial postoperative examinations included visual acuity (ETDRS) and digital fluorescein angiograms using a confocal Scanning Laser Ophthalmoscope (Heidelberg Retina Angiograph).
Results: Macular hole closure was achieved in 91 % of the eyes with air/gas-tamponades and in 87,5 % of the eyes with silicone oiltamponades. Mean postoperative visual improvement was 3,8 lines compared to 2,6 lines. Whereas we noted angiographic macular edema in 92,4 % of silicone oil-tamponated eyes, it occured in 78,9 % of air/gastamponated eyes (average 6 months postoperative). Silicone oil was removed in average 2,75 months after surgery.
Conclusion: The results indicate that anatomic hole closure can be achieved in the majority of patients with temporary silicone oil tamponade. However, compared to air/gas-tamponade there was a trend for a lesser extend of visual improvement and a higher prevalence of angiographic macular edema. The role of the latter in the occurence of the "latereopening" phenomen is assessed in an expanded ongoing longitudinal study.
support: Research Fund State of Baden-Württemberg 500/2000

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