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[Surgical treatment of post-traumatic macular holes]
E Barreau1, P Massin, M Paques
1Service d'Ophtalmologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris.
Background:
Macular hole is a rare complication of blunt ocular trauma. Little is known about its spontaneous course and only a few operated cases have been reported.
Method:
We present five cases of post-traumatic macular holes, 4 of which have been operated on.
Results:
In one case, the hole sealed spontaneously due to the formation of a slightly contractile epimacular membrane, and visual acuity improved from 0.1 to 0.5. The other four cases underwent vitrectomy, posterior hyaloid stripping, fluid-gas exchange and 12 days of postoperative positioning. In addition, two of these cases had autologous platelet injection. The macular hole closed in 3 of the 4 cases and vision improved in two.
Conclusion:
Traumatic macular holes can close spontaneously, although this is rare. Usually, surgery with or without healing adjuvants is needed to close the hole. Visual results may be good if there is no damage to the subfoveal retinal pigment epithelium or to Bruch's membrane.