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INFUSION-INDUCED MACULAR HOLES IN PARS PLANA VITRECTOMY: A CASE SERIES OF SIX PATIENTS
Hannah Shuman1, Vichar Trivedi1, Dhir Patwa1
1Department of Ophthalmology, School of Medicine, Kresge Eye Institute/Wayne State University, Detroit, Michigan.
Retinal Cases & Brief Reports
|February 11, 2025
Summary
Iatrogenic macular holes can occur during pars plana vitrectomy (PPV) due to infusion fluid flow. Surgeons should position cannulas away from the posterior pole in diabetic patients with retinal detachments to prevent this complication.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Pars plana vitrectomy (PPV) is a common surgical procedure for various retinal conditions.
- Iatrogenic complications can arise during PPV, necessitating careful surgical technique.
Purpose of the Study:
- To report a series of six cases of iatrogenic macular holes.
- To investigate the role of infusion fluid flow in inducing macular holes during 25-gauge PPV.
Main Methods:
- Retrospective case series.
- Analysis of six patients treated at Kresge Eye Institute (2018-2024).
Main Results:
- Five of six patients had diabetes mellitus and proliferative diabetic retinopathy.
- The complication occurred primarily during repair of tractional retinal detachments.
- Postoperative visual acuity varied, with two patients showing improvement.
Conclusions:
- Infusion fluid dynamics during PPV can lead to iatrogenic macular hole formation.
- Recommend positioning infusion cannulas away from the posterior pole in high-risk diabetic patients.
- Mitigating this risk is crucial for preserving visual function in complex retinal cases.
