ECCENTRIC MACULAR HOLES AS A POSTOPERATIVE COMPLICATION OF MACULAR SURGERY IN BLACK AFRICANS

The objective of this study is to report on the incidence and the characteristics of eccentric macular holes as a complication of macular surgery with internal limiting membrane peeling in a black African population.

This is a retrospective consecutive case series. Files of 125 patients who received macular surgery were reviewed, and 14 eyes of 14 patients were included in this study. Intervention consisted of pars plana vitrectomy with internal limiting membrane peeling for a full-thickness macular hole or epiretinal membrane. The main outcome measures were the development of eccentric macular holes, their characteristics (location, number), and best-corrected visual acuity.

Eccentric macular holes developed in 14 eyes of 14 patients with a mean age of 64.5 ± 9.4 years and a female predominance of 64%. The incidence of eccentric macular holes was 11.2%. Eccentric macular holes developed on average 4.4 ± 1.2 weeks after surgery. In 9 eyes (65%) location was temporal, in 3 eyes (21%) superotemporal, and in 2 eyes (14%) inferotemporal. Multiple holes were observed in 12 eyes (86%), and 5 eyes (35%) had confluent holes. Nine eyes (64%) had only full-thickness holes, 4 eyes (29%) had both full-thickness and lamellar holes, and 1 eye (7%) had only lamellar holes. Best-corrected visual acuity improved from 1.1 ± 0.33 logMAR to 0.89 ± 0.26 logMAR ( P = 0.017).

Eccentric macular hole formation showed a very high incidence in our setting and represents a main complication for macular surgery. In all cases, eccentric macular holes were formed in the temporal macula, and in most cases, they were multiple and full-thickness.