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Risk Factors for Macular Hole Development After Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment.

Yangyiran Xie¹, Rebecca Z Lin², Xiangyu Ji³

¹Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA.

Journal of Vitreoretinal Diseases

|August 13, 2025

Summary

This summary is machine-generated.

Eyes developing cystoid macular edema after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair face the highest risk of macular hole (MH) formation. MHs typically form months post-surgery, underscoring the need to manage edema and epiretinal membranes.

Keywords:

cystoid macular edema epiretinal membrane macular hole pars plana vitrectomy rhegmatogenous retinal detachment

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Area of Science:

Ophthalmology
Retinal Surgery
Macular Diseases

Background:

Rhegmatogenous retinal detachment (RRD) repair often involves pars plana vitrectomy (PPV).
Macular hole (MH) formation can be a complication following PPV for RRD.
Identifying risk factors for MH post-RRD repair is crucial for patient outcomes.

Purpose of the Study:

To determine intraoperative and postoperative risk factors associated with macular hole (MH) development after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).

Main Methods:

Retrospective case-control study design.
Matched 44 eyes with post-PPV MH (cases) to 44 eyes without MH (controls) using propensity scores.
Analyzed demographic, preoperative, RRD, and postoperative factors including perfluorocarbon usage, epiretinal membrane (ERM), and cystoid macular edema (CME).

Main Results:

Macular hole formation occurred at a median of 6.3 months post-PPV.
Higher rates of perfluorocarbon usage during RRD repair were observed in the MH group (16% vs 0%).
Post-PPV cystoid macular edema (CME) was significantly more prevalent in eyes that developed MH (75.9% vs 9.1%; P < 0.001).
Epiretinal membrane (ERM) formation was also higher in the MH group (61% vs 43%).

Conclusions:

Postoperative cystoid macular edema (CME) is the most significant risk factor for macular hole (MH) formation after PPV for RRD.
Macular hole development is a delayed complication, often occurring months after initial surgery.
Managing postoperative CME and mitigating ERM formation are vital for preserving visual prognosis after RRD repair.