Late reopening of an initially successfully closed macular hole after 12 years

An uncommon late complication after successful initial surgical closure of a full-thickness macular hole is reopening.

A retrospective interventional case report.

A 58-year-old pseudophakic woman presented with 6 weeks of decreased vision in her right eye. She was found to have a full-thickness macular hole, which was successfully repaired through pars plana vitrectomy, epiretinal membrane peeling, gas-fluid exchange with 25% SF6, and 7 days of face-down positioning. Twelve years later, she presented with new metamorphopsia and visual acuity of 20/50 in the right eye. Examination revealed reopening of the macular hole.

Despite high rates of surgical success, the reopening of initially closed macular holes can occur at any time postoperatively but has been reported more frequently in the first few months, though late reopenings have been observed. This is the latest reopening of a macular hole reported in the literature, occurring 12 years after initial successful surgical closure. This case highlights the importance of long-term follow-up and raises questions about why macular holes can reopen so late after initial successful closure.