Surgical Outcomes for Persistent Macular Hole After Ocriplasmin

Ophthalmic Surg Lasers Imaging Retina. 2015 Jul-Aug;46(7):732-6. doi: 10.3928/23258160-20150730-07.

Abstract

Background and objective: To report surgical and visual acuity outcomes in eyes with unresolved full-thickness macular hole (FTMH) after treatment with ocriplasmin who subsequently underwent vitrectomy.

Patients and methods: Retrospective case series of four eyes. Vision and anatomy via optical coherence tomography (OCT) were assessed before and after intravitreal ocriplasmin as well as 6 months after subsequent vitrectomy.

Results: Initial visual acuity ranged from 20/70 to 20/200. OCT showed focal vitreomacular traction (VMT) with FTMH ranging from 136 to 311 µm in diameter. Following ocriplasmin, VMT released in all four eyes without closure of the FTMH. All FTMHs enlarged over follow-up after ocriplasmin (mean increase 133 µm). Subsequent vitrectomy led to anatomic FTMH closure in all eyes. Final vision improved in all eyes (20/30 to 20/70).

Conclusion: Initial ocriplasmin treatment of FTMH in this series of patients did not reduce the effectiveness of vitrectomy, which was required for definitive FTMH repair.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Fibrinolysin / therapeutic use*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Peptide Fragments / therapeutic use*
  • Retinal Perforations / diagnosis
  • Retinal Perforations / drug therapy
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Failure
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*

Substances

  • Fibrinolytic Agents
  • Peptide Fragments
  • microplasmin
  • Fibrinolysin