Our Summary

This study looks at two different surgical treatments for a particular kind of eye condition called primary full-thickness macular holes (FTMH). These holes occur in the part of the eye responsible for detailed, central vision.

The researchers looked at over 400 past surgeries. Some of these surgeries were ‘vitrectomies’, where the surgeon removes some of the jelly-like substance that fills the eye. Others were ‘phacovitrectomies’, where the surgeon removes the cloudy lens of the eye (like in a cataract operation) as well as some of the jelly-like substance.

The researchers wanted to see if one kind of surgery was better than the other at closing these holes, and also at improving patients’ vision. They also wanted to see if there were any differences in complications during and after the operation.

Their results showed that both types of surgery were equally effective at closing the holes and improving vision, and there was no significant difference in the rate of complications. The surgery was successful at closing the holes in over 90% of cases, and patients’ vision improved significantly after the operation.

In other words, for patients over 50 years with this particular eye condition, having the combined surgery didn’t have any extra benefits compared to just having the vitrectomy.

FAQs

  1. What is the difference between vitrectomy and phacovitrectomy surgeries?
  2. Did the study show any significant difference in effectiveness between vitrectomy and phacovitrectomy surgeries in treating primary full-thickness macular holes (FTMH)?
  3. Was there a difference in complication rates between the two types of surgery according to the study?

Doctor’s Tip

However, it’s important to note that every patient is different, and your doctor will assess your individual situation before recommending a specific treatment plan. It’s important to follow your doctor’s post-operative instructions carefully to ensure the best possible outcome. Additionally, regular follow-up appointments with your eye doctor are crucial to monitor your progress and address any concerns that may arise.

Suitable For

Patients with primary full-thickness macular holes (FTMH) are typically recommended vitrectomy, as this surgery has been shown to be effective at closing the holes and improving vision in over 90% of cases. This condition is more common in patients over 50 years old, so this age group may be particularly recommended for vitrectomy. Additionally, patients with significant visual impairment or symptoms related to the macular hole may also be good candidates for this surgery. Ultimately, the decision to recommend vitrectomy will depend on the individual patient’s specific condition and needs, and should be made in consultation with an eye care specialist.

Timeline

Before the vitrectomy:

  1. Patient is diagnosed with a primary full-thickness macular hole (FTMH).
  2. Patient discusses surgical options with their ophthalmologist.
  3. Patient undergoes pre-operative evaluations and tests.
  4. Surgery date is scheduled.

During and immediately after the vitrectomy:

  1. Patient is put under anesthesia.
  2. Surgeon performs the vitrectomy, removing some of the jelly-like substance in the eye.
  3. Surgery typically lasts between 1-2 hours.
  4. Patient may experience discomfort, redness, and blurry vision immediately after the surgery.
  5. Patient is given post-operative instructions and medications.

After the vitrectomy:

  1. Patient is required to follow up with their ophthalmologist for regular check-ups.
  2. Patient may need to wear an eye patch or shield for a few days post-surgery.
  3. Patient may experience gradual improvement in vision over the following weeks to months.
  4. Patient may need to avoid strenuous activities and heavy lifting for a period of time.
  5. Patient may need to use eye drops or other medications as prescribed by their ophthalmologist.

Overall, the timeline for a patient before and after vitrectomy involves pre-operative evaluations, the surgical procedure itself, and post-operative care and follow-up appointments to monitor recovery and vision improvement.

What to Ask Your Doctor

  1. What is the success rate of vitrectomy for closing macular holes?
  2. What are the potential risks and complications associated with vitrectomy?
  3. How long is the recovery period after vitrectomy surgery?
  4. Will I need to follow a specific post-operative care regimen?
  5. Are there any alternative treatments to vitrectomy for macular holes?
  6. How soon after surgery can I expect to see improvements in my vision?
  7. Will I need to undergo any additional treatments or follow-up appointments after the surgery?
  8. Are there any factors that may affect the success of the surgery, such as age or overall health?
  9. What are the potential long-term effects of vitrectomy for macular holes?
  10. How experienced are you in performing vitrectomy surgeries for this particular condition?

Reference

Authors: Valmaggia C, Kostadinov F, Lang C, Guber J. Journal: BMC Ophthalmol. 2021 Apr 10;21(1):174. doi: 10.1186/s12886-021-01918-2. PMID: 33838649