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Macular hole surgery in an eye with an optic pit
M Bechmann1, A J Mueller, A Gandorfer
1Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. mbechman@ak-i.med.uni-muenchen.de
Purpose:
To report an eye with a full-thickness macular hole and an associated optic pit and the noteworthy intraoperative findings.
Methods:
Case report. A 56-year-old woman presented with visual acuity LE: 20/100, a full thickness macular hole, and an optic pit. Optical coherence tomography and ophthalmic examination were performed preoperatively and postoperatively.
Results:
Although usually a macular hole associated with an optic pit tends to be a lamellar and characterized by outer layer defects within preexisting macular detachments or schisis-like cavities, this type of macular hole was not presented in this case. Although the macular hole resembled the idiopathic type on clinical examination as well as on optical coherence tomography, it could only be closed in the third surgical attempt after using silicone oil as a long-standing tamponade. Peeling of an epiretinal membrane or the internal limiting membrane was not possible during any of the three surgeries.
Conclusion:
Our observations suggest that in cases of macular hole in association with optic pit, instillation of silicone oil should be considered in the first surgical procedure, especially if no epiretinal membrane or internal limiting membrane peeling is possible intraoperatively.