Postoperative eccentric macular holes after surgery for vitreomacular interface diseases
Esat Yetkin1, Mehmet Citirik2, Mehmet Yasin Teke2
1Ankara Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Cd. No: 59, 06230, Altindag, Ankara, Turkey. av3sta21@gmail.com.
International Ophthalmology
|November 14, 2019
Summary
Postoperative eccentric macular holes (ECMH) can occur after vitreomacular interface surgery, such as epiretinal membrane (ERM) or macular hole (MH) repair. These holes are typically asymptomatic and do not require intervention.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Diseases
Background:
- Vitreomacular interface abnormalities, including epiretinal membranes (ERM), macular holes (MH), and vitreomacular traction (VMT), are common indications for pars plana vitrectomy (PPV).
- Postoperative complications can arise, necessitating a thorough understanding of their incidence and characteristics.
Purpose of the Study:
- To determine the incidence, clinical features, and outcomes of eccentric macular holes (ECMH) developing after PPV for ERM, MH, and VMT.
- To explore potential mechanisms underlying the formation of postoperative ECMH.
Main Methods:
- A retrospective analysis of 711 eyes undergoing 25-gauge PPV for ERM, MH, or VMT between 2010 and 2016.
- Mean follow-up duration was 19 months, assessing for the development of ECMH.
Main Results:
- Eight patients (1.12%) developed ECMH, primarily after ERM or MH surgery; none occurred after VMT surgery.
- ECMH appeared a mean of 7.25 weeks postoperatively, mostly temporal to the fovea, and were asymptomatic.
- No associated complications like retinal detachment or neovascularization were observed, and no further treatment was needed.
Conclusions:
- Eccentric macular holes (ECMH) are a potential complication of vitreomacular interface surgery.
- These postoperative ECMH are generally asymptomatic, located in the parafoveal region, and do not require intervention.
- Potential causes include internal limiting membrane (ILM) peeling, Muller cell damage, residual ILM contraction, or iatrogenic trauma.
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