macular hole treatment

When I research treatment for macular hole, I only read about vitrectomy with an gas bubble. If a patient has already had a vitrectomy, what is done for macular hole?  Just inject the gas bubble and lie flat for weeks??

[John C Hagan III, MD, FACS, FAAO]

Sometimes serum is injected into the hole. It is to keep hole from gettting bigger and often does not make vision better.

JCH MD

[Nanny55]

This is the first I've heard of a serum.  If the serum can keep the hole from enlarging, is it then possible to avoid the macular hole surgery?  How often would you need to receive the injection and is this a treatment that one can use for years to avoid surgery?  Also, does a hole stop expanding?  How often should one go to the Opt;Dr to monitor the hole to make sure it had stopped enlarging. If one opts to no surgery when having a macular hole does it lead to blindness? How big can a hole be until one needs surgery, or do you ever have to have surgery, just because you have a hole?  We've been to Drs, we just want to know what u think!!

[John C Hagan III, MD, FACS, FAAO]

Patients with macular holes should monitor their eyes daily with amsler grid. Visits to the ophthalmologist will vary depending on many factors. Certainly no longer than yearly and in many cases every 6 months or more often.

Serum is injected as part of macular hole closing surgery.  

Macular holes can lead to legal blindness but not total blindness since they don't affect peripheral vision.

JCH MD

[KellyComfort]

I try to keep up on macular hole repair as I have a business related to the recovery equipment.   A recent major retinal convention I attended didn't even mention what I assume Dr.Hagan means to be autologous serum for macular holes.  Even the studies involving this serum were only as an adjunct to regular vitrectomy surgery and most of these studies were a few years ago.  It was not meant to delay surgery, it was studied to see if it would facilitate hole closure with surgery.

The important thing to remember when deciding on surgery for MH is that fresher smaller holes have a better chance of surgical success than older larger holes.  Another thing to think about - if you lost the vision in the other eye, would you be able to read, drive etc with the vision you currently have in the MH eye?

[John C Hagan III, MD, FACS, FAAO]

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