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Evolution and successful management of a large postvitrectomy macular hole
Dhananjay Shukla1, Jay Kalliath2
1Retina-Vitreous Service, Ratan Jyoti Netralaya, Gwalior, Madhya Pradesh, India.
Oman Journal of Ophthalmology
|February 10, 2023
Summary
A novel technique successfully closed a large secondary macular hole after vitrectomy by extending internal limiting membrane peeling. This procedure led to significant visual acuity improvement over five years.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- A large secondary macular hole developed postvitrectomy in a patient with optic pit maculopathy.
- The hole was horizontally oval and measured 658 × 824 μ, with best-corrected visual acuity (BCVA) of 20/200.
Observation:
- Internal limiting membrane (ILM) peeling was extended temporally, following the horizontal orientation of the macular hole.
- A repeat gas tamponade was administered concurrently with the extended ILM peeling.
Findings:
- The secondary macular hole closed successfully without a central defect.
- BCVA initially remained stable but improved to 20/63 by the 5-year follow-up.
Implications:
- Temporal extension of ILM peeling is an effective surgical modification for large, horizontally oval secondary macular holes.
- This technique offers a promising approach for improving visual outcomes in complex macular hole cases.
Keywords:
Internal limiting membranemacular hole shapeoptic pit maculopathysecondary macular holevitrectomyMore Related Videos
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