난치성 황반원공 치료에서 고점도 실리콘기름의 치료 효과: 증례보고

Abstract

Purpose: To report a case of recurrent macular hole that formed after vitrectomy for proliferative vitreoretinopathy with retinal detachment and was successfully treated using high viscosity silicone oil (HVSO). Case summary: A 48-year-old man visited our clinic for blurred vision in his left eye. Best corrected visual acuity (BCVA) was 20/1,000 in his left eye. A horseshoe tear at 2 o’clock and bullous retinal detachment (RD), involving macula was found on fundus exam. The patient underwent pars plana vitrectomy (PPV), inner limiting membrane (ILM) peeling, and sulphurhexafluoride (SF6) injection. After 3 weeks, a macular hole was found in his left eye. He underwent additional PPV, autologous ILM transplantation, autologous platelet concentrate injection, and 20% SF6 gas injection. However, the hole remained 5 weeks after the second operation. Thus, he underwent an additional gas injection using perfluoropropane. When the macular hole still had not resolved, a third SF6 gas injection was performed. Three weeks later, the hole was still present and the patient underwent a fourth operation using HVSO. Two months after the last operation, the hole was completely closed, and was maintained at 8 months without any complications from emulsification. The oil was removed, and the hole remained closed for 3 years. BCVA at the last follow up was 20/1,000. Conclusions: We successfully treated chronic refractory macular hole using HVSO, which occurred secondary to vitrectomy for RD. Based on this case, HVSO might be an alternative to traditional gas tamponade for treating chronic refractory macular hole after vitrectomy for RD.