Iatrogenic subfoveal diamond particle after macular hole repair surgery

To discuss surgical options and visual outcome when faced with a diamond intraoperative foreign body during macular hole surgery.

Case study of an iatrogenic in-the-macular-hole diamond particle noted during macular hole surgery. No attempt to retrieve the diamond from the macular hole was made during surgery.

Forty-seven-year-old female patient with a 483-μm macular hole.

The patient's macular hole closed over the diamond particle, making it subfoveal. The visual acuity improved from 20/120 to 20/40 with resolution of metamorphopsia.

It is likely that the inert nature and small size of diamond particles do not significantly affect visual acuity or hole closure and do not cause retinal toxicity. The authors discourage aggressive attempts to remove such particles during surgery.