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Good visual outcome after repair of a very large macular hole with neurosensory retinal operculum
David M Wu1, Amani A Fawzi, Marta A Recasens
1*Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; †Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ‡Macular Retinal Vitreal Associates, Glendale, California; and §Doheny Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California.
Purpose:
To describe a favorable outcome after the surgical repair of a very large macular hole with a neurosensory operculum.
Methods:
Case report. A 42-year-old man with a history of decreased vision for 3 months was found to have vision of 20/400, a very large macular hole (1159 μm in diameter), and an operculum suspended on the posterior hyaloid above the hole.
Results:
Vitrectomy and internal limiting membrane peel were performed. The operculum was processed for histology and found to contain neurons and glial cells. Fourteen months later, the patient's vision improved to 20/60.
Conclusion:
Very large macular holes have traditionally been considered to have a poor prognosis. Here, we demonstrate that such large holes can be repaired with good visual outcome, even in the setting of an operculum consisting of avulsed neural retina.
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