[Posterior segment complications after macular hole surgery]

Fifty-three patients with stage III or stage IV idiopathic macular holes who underwent vitrectomy were reviewed. Posterior segment complications were noted in 20 (38%) of patients. These included peripheral retinal breaks (21%), peripheral visual field loss of unknown etiology (8%), rhegmatogenous retinal detachment caused by peripheral retinal break (6%), late reopening of the hole (4%), and retinal pigment epithelium loss under the hole (4%). The final visual acuity was two lines or more worse than preoperative visual acuity in 10% of these complicated eyes and in 9% of eyes without posterior segment complications. Patients with peripheral retinal breaks or retinal detachment had significantly shorter duration of macular hole symptoms (p < 0.01) than those without these complications. Posterior segment complications after vitrectomy for macular hole appear to be more common than expected, but the effect of such complications on final visual outcome was not significant.