DELAYED CLOSURE OF A FULL-THICKNESS MACULAR HOLE AFTER PARS PLANA VITRECTOMY WITH INTERNAL LIMITING MEMBRANE FLAP

The aim of this study is to describe a patient with delayed closure of a stage 3 full-thickness macular hole after pars plana vitrectomy.

This is a retrospective case report. Details of the case were obtained from the electronic patient record system, Medisoft.

A 65-year-old man was referred with a left stage 3 full-thickness macular hole measuring 720 μ m and visual acuity of 6/36. He underwent phacovitrectomy, internal limiting membrane peel with an inverted internal limiting membrane flap, and C 3 F 8 gas tamponade. Seven weeks after surgery, the macular hole was smaller at 196 μ m but remained open. The patient was listed for repeat surgery; however, another 13 weeks later, the full-thickness macular hole demonstrated type 2 closure without further intervention.

Delayed macular hole closure after pars plana vitrectomy is rare. In cases where there has been a substantial decrease in the size of a full-thickness macular hole after surgery without full closure, a short period of observation to allow for further closure may be appropriate before reconsidering surgery.