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Charles Clifton Wykoff, Daniel Croft, Eric Chen, Tien P Wong, David M Brown; Full Thickness Macular Hole Development After Rhegmatogenous Retinal Detachment Repair. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1080.
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© ARVO (1962-2015); The Authors (2016-present)
To report a series of patients who developed a full thickness macular hole (MH) following primary repair of rhegmatogenous retinal detachment (RD).
Retrospective review of the demographic, clinical, optical coherence tomography (OCT), and surgical data of patients who underwent RD repair and subsequently developed MH between 1/1/2000 and 5/1/2013.
Seven eyes (3 left and 4 right) from 4 women and 3 men (mean age 62 years, range 52-71 years) which developed MH after primary RD repair were identified. Surgical RD repair was performed with scleral buckling (SB) alone in 3 patients, pars plana vitrectomy (PPV) alone in 2 patients, and both SB and PPV in 2 patients. The mean interval between RD surgery and MH diagnosis was 278 days (range, 28-1,203 days), with 4 eyes developing MH in less than 70 days. At the time of MH diagnosis, an epiretinal membrane (ERM) was observed within the macula in all cases. All 7 patients underwent PPV with internal limiting membrane peeling and all experienced successful MH closure. Last clinical evaluation was performed a mean of 527 days (range 43-2,034 days) after MH surgery. The mean logarithm of the minimal angle of resolution (logMAR) (approximate Snellen equivalent) was 1.75 (counting fingers at 5 feet), 1.0 (20/200), 1.31 (20/400), and 0.74 (20/100) at RD presentation, after RD repair, at MH diagnosis, and at last follow-up, respectively. Statistically significant visual improvements were observed after both primary RD repair (P=0.01) and after MH closure (P=0.01).
MH may develop following primary RD repair with SB, PPV, or both. In this series of 7 eyes, ERM was associated with all MH cases. All 7 MH were successfully closed with PPV and ILM peeling. Significant visual gain was observed after both primary RD repair as well as subsequent MH closure.
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