J Korean Ophthalmol Soc.  2014 Oct;55(10):1487-1492. 10.3341/jkos.2014.55.10.1487.

Characteristics and Surgical Outcome of Macular Holes Developing after Rhegmatogenous Retinal Detachment Repair

• Han SY
• Yoo SG
• Lew YJ
• Yu SJ
• Han JI
• Lee DW
• Cho SW
• Lee TG
• Kim CG
• Kim JW
• Kim JY

• KMID: 2216867
• DOI: http://doi.org/10.3341/jkos.2014.55.10.1487

Abstract

PURPOSE
To report the characteristics and surgical outcome of macular holes (MHs) that develop after rhegmatogenous retinal detachment (RRD) repair.
METHODS
A retrospective chart review was performed in patients who developed a new full-thickness macular hole after RRD repair between May 2010 and July 2013. For eyes that underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade for MH repair, main outcomes included macular attachment status and postoperative visual acuity.
RESULTS
Fourteen full-thickness MHs were detected in a series of 2,815 eyes (0.49% prevalence) that had undergone prior RRD surgery. Ten MHs developed after primary vitrectomy and four after scleral bucking surgery. The fovea was detached in eight of the 14 eyes at the time of RRD. Fourteen of 14 eyes were managed by pars plana vitrectomy, internal limiting membrane peeling, and intravitreal gas tamponade, and 12 of 14 eyes achieved MH closure. Mean preoperative Snellen best-corrected visual acuity (BCVA) was 20/63 (+/-0.25). Nine of 14 eyes had an improvement in visual acuity of at least two Snellen lines, and five eyes remained unchanged.
CONCLUSIONS
In this small retrospective study, the secondary MHs were found predominantly in foveal detachments after RRD repair, most commonly occurring after primary vitrectomy. In conclusion, the surgical outcome and postoperative visual acuity improvement were satisfactory, although the final BCVA depended on the macular status during the RRD.

Keyword

Macular hole; Retinal detachment; Surgical outcome

MeSH Terms

Humans
Membranes
Retinal Detachment*
Retinal Perforations*
Retrospective Studies
Visual Acuity
Vitrectomy

Figure

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  Figure 1. Optical coherence tomography images of patient number 12 that were taken at the diagnosis of retinal detachment (macular-spared) (A), 22 months after rhegmatogenous retinal detachment repair, macular hole had developed (B). 2 months after additional vitrectomy, internal limiting membrane peeling and fluid-gas exchange, macular hole had closed (C). The best-corrected visual acuity measured at each time point was 20/40, 20/50, 20/25, respectively.

Reference

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