Macular hole after vitrectomy for primary rhegmatogenous retinal detachment. 2012

Ido Didi Fabian, and Elad Moisseiev, and Joseph Moisseiev, and Iris Moroz, and Adiel Barak, and Amir Alhalel
The Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. didifabian@gmail.com

OBJECTIVE To report a series of full-thickness macular holes (MH) that developed after pars plana vitrectomy for rhegmatogenous retinal detachment (RRD). METHODS A retrospective review of the demographic and medical data, including optical coherence tomography studies of 6 patients (7 eyes) who underwent pars plana vitrectomy for RRD and subsequently developed MH. RESULTS There were 4 women and 2 men with a mean age of 60 ± 10 years (range, 50-79 years). The mean interval between RRD repair and MH formation was 20 ± 18 months (range, 1-48 years). Five eyes underwent surgery to repair the MHs, four of which were closed at the last follow-up. Two eyes were not operated, one because of unfavorable prognosis, and in the other, which presented with an epiretinal membrane before the development of the MH, the hole closed spontaneously. In all operated cases, the inner limiting membrane was peeled during MH surgery. The mean logarithm of the minimal angle of resolution was 0.73, 0.53, 0.77, and 0.57 at RRD presentation, after surgical repair of RRD and before MH diagnosis, at MH presentation, and at last follow-up, respectively. The study subjects accounted for 1.1% of our 609 patients who underwent pars plana vitrectomy for primary RRD during the study period. CONCLUSIONS Macular hole may develop after pars plana vitrectomy for RRD, and these cases can be surgically repaired. The pathogenesis of the formation of these holes remains unclear.

UI MeSH Term Description Entries
D007557 Israel A country in the Middle East, bordering the Mediterranean Sea, between Egypt and Lebanon. The capital is Jerusalem.
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012167 Retinal Perforations Perforations through the whole thickness of the retina including the macula as the result of inflammation, trauma, degeneration, etc. The concept includes retinal breaks, tears, dialyses, and holes. Macular Holes,Retinal Breaks,Retinal Dialyses,Retinal Holes,Retinal Tears,Break, Retinal,Breaks, Retinal,Dialyses, Retinal,Hole, Macular,Hole, Retinal,Holes, Macular,Holes, Retinal,Macular Hole,Perforation, Retinal,Perforations, Retinal,Retinal Break,Retinal Dialyse,Retinal Hole,Retinal Perforation,Retinal Tear,Tear, Retinal,Tears, Retinal

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