Korean J Ophthalmol.  2005 Sep;19(3):183-188. 10.3341/kjo.2005.19.3.183.

The Effects of Laser Photocoagulation on Reopened Macular Holes, as Assessed by Optical Coherence Tomography

• Cho HY
• Kim MR
• Kang SW

• KMID: 754422
• DOI: http://doi.org/10.3341/kjo.2005.19.3.183

Abstract

PURPOSE
To evaluate the effects of laser photocoagulation on reopened macular holes. METHODS: This study involved 9 eyes from 9 patients who underwent laser photocoagulation coupled with fluid-gas exchange for reopened macular holes. The photocoagulation was performed at the center of the macular hole. Closure of the reopened hole was categorized by optical coherence tomography (OCT) according to the presence (type 1 closure) or absence (type 2 closure) of continuity in the foveal tissue. Best corrected visual acuity (BCVA), closure types, and complications were assessed. RESULTS: Upon final examination, all macular holes were found to have closed. Six eyes were classified as type 1 closure, and three were classified as type 2 closure. The mean BCVAs, before and after laser photocoagulation, were 0.11 and 0.31, respectively (P< .05). The eyes with type 1 closure were associated with shorter symptom durations and greater visual improvement than those with type 2 closure (P< .05). CONCLUSIONS: The combination of laser photocoagulation and fluid-gas exchange appears to be a safe and effective treatment for reopened macular holes. Early intervention should be encouraged to ensure complete hole closure and improved visual outcomes.

Keyword

Fluid-gas exchange; Laser photocoagulation; Macular hole; Optical coherence tomography; Recurrent macular hole

MeSH Terms

*Tomography, Optical Coherence
Retinal Perforations/*pathology/*surgery
Recurrence
Middle Aged
Male
*Laser Coagulation
Humans
Female
Aged

Figure

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  Fig. 1 Diagram representation of the laser photocoagulation technique used for closing a reopened macular hole after vitreous surgery. Laser spots were applied directly to the RPE at the center of the reopened hole.

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  Fig. 2 Symptom duration in this case (case 1 in Table 1) was 2.3 months, and the hole diameter measured before vitrectomy was 696 µm (A). Type 2 closure of the macular hole was noted 14 days after vitrectomy (B). At 36 days after vitrectomy, we noted the reopening of the macular hole with a diameter of 812.5 µm (C). After laser photocoagulation and fluid gas exchange for the reopened macular hole, type 1 closure was achieved (D). Final visual acuity was 0.5.

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  Fig. 3 The symptom duration in this case (case 7 in Table 1) was 51 months, and the hole diameter measured before vitrectomy was 755.5 µm (A). The reopened macular hole with a diameter of 864.5 µm was noted in the optical coherence tomography 2 months after the procedure (B). Type 2 closure of the reopened macular hole is demonstrated after laser photocoagulation and fluid gas exchange (C). Final visual acuity was 0.2.

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  Fig. 4 The changes in the best corrected visual acuity according to the type of macular hole closure.

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