reoperation than those with a flat rim around the macular hole (Hillenkamp et al. 2007).

9.3Microplasmin

Enzymatic vitreolysis shows promise as a method of inducing vitreal separation. This may have a role for treating grade 0, grade 1 and grade 2 macular holes. Hundred and twenty-five microg microplasmin can be injected intravitreally to induce separation in up to 44 % of patients with vitreomacular adhesion (de Smet et al. 2009).

9.4Summary

PPV is established as the treatment of macular hole. Variations in technique exist relating to intraocular dyes, duration of gas tamponade and use of posturing, but success rates are high if the operation is performed early in the disease process.

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