Visually significant persistent outer retinal fluid following closure of a macular hole

We report two cases of persistent outer retinal fluid defects following macular hole surgery.

Twenty-eight consecutive patients who underwent macular hole surgery performed by a single surgeon were examined pre- and postoperatively using slit-lamp biomicroscopy and optical coherence tomography (OCT).

Two patients from this series were identified by OCT as having persistent outer retinal fluid defects after macular hole surgery, despite closure of the holes on biomicroscopy. One patient had only a small defect present at 6 weeks, with very good visual improvement, which was later shown to have resolved. The second had a large persistent defect and no postoperative improvement in vision despite the eventual resolution of the fluid 17 months later.

Large pockets of persistent outer retinal fluid defects as shown on OCT may reduce final visual acuity in patients following macular hole surgery.