Nonposturing surgery for Persistent Macular Hole using Heavy Silicone Oil (Oxane Hd) Endotamponade

Purpose:
To investigate the usefulness of Oxane HD for nonposturing surgery on persistent (redo) macular holes by reporting visual and anatomical outcomes as well as complications in a consecutive case series.

Methods:
Eighteen consecutive patients with a persistent macular hole were recruited from 2008 to 2016. Pre- and postoperative visual acuity and optical coherence tomography data were recorded. Anatomical success was defined as complete circumferential neurosensory reattachment. Postoperative complications were actively looked for and noted.

Results:
Eighteen (100%) of the 18 persistent holes were closed on the first postoperative day. Visual acuity improved significantly in 15 (83.4%) of the 18 patients from baseline, mean change 0.62 log units (range, 0-1.72). Two (11.1%) of the 18 patients maintained their vision while 1 (5.5%) of the 18 patients lost more than 2 lines. No pre- or postoperative complications were noted.

Conclusion:
This is the largest prospective study on the use of heavier than water silicone oil to close persistent macular holes without the need for prone posturing. Oxane HD may be successfully used where conventional techniques have already failed and can be associated with functional recovery. Patients’ inability to posture need not preclude redo macular surgery.