Purpose: To evaluate the efficacy of air tamponade in idiopathic macular hole (iMH) surgery and of an additional intravitreal air injection in the treatment of persistent holes.
Methods: Retrospective, observational case series. Sixty eyes of 60 patients with an iMH underwent phacoemulsification of cataract (when appropriate), pars plana vitrectomy, and internal limiting membrane peeling, followed by air tamponade. Eyes with persistent holes underwent an additional intravitreal air injection within 1 week after surgery. The iMH closure rate and the best-corrected visual acuity were evaluated.
Results: In all 30 eyes with an iMH diameter <400 µm, the iMH closed after the primary surgery; however, only 17 of 30 eyes with an iMH diameter of ≥400 µm closed after the primary surgery. For the 13 eyes with persistent holes, an additional intravitreal air injection resulted in successful hole closure. There was no significant difference in the best-corrected visual acuity at the final follow-up between the closed subgroup and the initially unclosed subgroup after closure.
Conclusion: Pars plana vitrectomy combined with air tamponade effectively cured small iMHs. For large iMHs not closed after the primary surgery, an additional intravitreal air injection resulted in hole closure and achieved a good prognosis.