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Macular holes associated with diabetic tractional retinal detachments
John O Mason1, Mamta D Somaiya, Milton F White
1Department of Ophthalmology, Callahan Eye Foundation Hospital, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Background And Objective:
Evaluation of surgical treatment of full-thickness macular holes secondary to diabetic tractional retinal detachments was conducted.
Patients And Methods:
A retrospective review of medical records, fluorescein angiograms, fundus photographs, optical coherence tomography images, and operative findings of six consecutive patients with full-thickness macular holes and diabetic tractional retinal detachments was completed. Each eye was treated with pars plana vitrectomy, tractional retinal detachment repair, membranectomy, indocyanine green-assisted internal limiting membrane peeling, and intraocular gas tamponade.
Results:
Surgical intervention resulted in the closure of all full-thickness macular holes. Mean best-corrected visual acuity was 20/250 preoperatively and 20/100 postoperatively, with all patients having improvement after a mean follow-up of 10 months.
Conclusion:
Closure of tractional retinal detachments related to full-thickness macular holes can be achieved via pars plana vitrectomy, complete membranectomy, and intraocular gas. Vitrectomy with dissection of proliferative membranes helps to relieve the tractional forces responsible for full-thickness macular hole formation, enabling successful closure of the diabetic full-thickness macular holes and resulting in visual acuity improvement.
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