GaslEss Macular Hole Surgery

The investigators are testing a new surgical technique, that does not use the gas bubble and face down positioning. Instead, a licensed surgical gel and thin flap of retinal tissue seal the macular hole. Early small studies suggest the new technique is safe and works as well as standard surgery.

The investigators will invite 60 people with macular hole to take part in the study. Half will be randomly allocated to the new technique and half to standard surgery. All participants will return at regular intervals after surgery for review. The investigators will test their vision, examine their eyes, and ask participants to complete questionnaires about their treatment and vision.

The investigators aim to examine if the technique appears safe and works well at closing macular holes. It will also inform if a larger clinical trial is possible.

Inclusion criteria

• Requiring PPV to treat idiopathic (primary) FTMH.
• 18 years or older
• ETDRS BCVA letter score of 1 or better in the study eye
• Able to provide written informed consent

Exclusion criteria

General:

• Hypersensitivity to hyaluronate or other components of Healon Pro® viscoelastic
• Any major illness or major surgical procedure within 4 weeks
• Any other condition that, in the opinion of the investigator, would prevent the participant from granting informed consent or complying with the protocol

Study eye

• Previous vitreoretinal surgery, retinopexy, open-globe injury, or endophthalmitis
• Presence of fibrotic retinal proliferation or central epiretinal membrane (within 1 disc diameter of the fovea)
• Aphakia
• Current or former myopia greater than 6 dioptres
• Current or previous posterior uveitis or choroiditis
• Presence of other ocular co-morbidity that, in the opinion of the investigator, is likely to impair BCVA postoperatively or affect FTMH closure
• Current ocular or periocular infection, other than mild or moderate blepharitis
• Lens or media opacity that preclude adequate retinal assessment and imaging