gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Surgery of macular hole stage IV

Meeting Abstract

  • corresponding author K. Engelmann - Klinik mit Poliklinik für Augenheilkunde am Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden
  • S. Domann - Klinik mit Poliklinik für Augenheilkunde am Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden
  • T. Maulhardt - Klinik mit Poliklinik für Augenheilkunde am Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden
  • D. Sandner - Klinik mit Poliklinik für Augenheilkunde am Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.01.17

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog419.shtml

Veröffentlicht: 22. September 2004

© 2004 Engelmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

A variety of studies proved macular hole surgery successful, with stage and duration of the disease having vital influence on anatomical and visual outcome. Surgery of macular hole stage IV has seldomly been described successful or was often excluded from studies.

Methods

During 6/03 - 1/04 only patients with macular holes stage IV were sent to the clinic (n=27). These patients were treated with pars plana vitrectomy, ILM-peeling and long-lasting gas tamponade (C3F8) to achieve at least anatomical success. Autologous platelet preparations were used as biological adjuvantium. Compared to former studies, these platelet preparations were applied within 24h after donation, with higher application volumes and prolonged incubation times. Patients were seen at 6 weeks and 6 months post surgery.

Results

At 6 weeks post surgery, 18 of 27 treated patients showed closure of the macular hole, 3 patients had a persisting macular hole, in 5 cases the follow-up data are incomplete up to now, 1 patient developed retinal detachment. Anatomical results exceed visual outcome, although 3 patients achieved vision improvement of ≥2 lines. Nevertheless, more than 50% of the patients reported improvement in the Watzke-Allen slit lamp beam test and Amsler grid test. Results ½ year post surgery are still to be evaluated.

Conclusions

An intensified treatment with platelet preparations as adjuvantium seems to improve at least the anatomical outcome and the subjective experience of the patients after macular hole surgery at stage IV. Despite positive results it is still recommended to see patients at earlier stages and to improve the screening with regard to this disease.