Abstract
Purpose:
To describe the clinical characteristics and optical coherence tomography (OCT) outcomes for patients undergoing pars plana vitrectomy (PPV) for full thickness macular holes (FTMH) that developed after surgery for symptomatic vitreomacular traction (VMT).
Methods:
This is a non-comparative, interventional, consecutive case series from January 2007 through February 2014. Patients with comorbid ocular conditions (macular holes, diabetic macular edema, advanced glaucoma, etc) were excluded. Preoperative and postoperative clinical characteristics and OCT features were compared.
Results:
A total of 4 eyes that developed full thickness macular holes following PPV for VMT were included. The mean age at time of surgery was 70.5 years (range of 56 to 82). Mean best corrected visual acuity prior to vitrectomy was 20/55 (range of 20/30 to 20/200). During initial vitrectomy, internal limiting membrane was peeled in 3 (75%) eyes. No intraoperative macular hole was noted. The average time between initial surgery and identification of the full thickness macular hole was 144 days (range of 44-236 days). After PPV for FTMH, 3 of 4 eyes (75%) achieved macular hole closure. The fourth patient declined further surgery and best corrected visual acuity remained at 20/400. Mean final best corrected visual acuity after successful macular hole repair in 3 eyes was 20/59 (range of 20/25 to 20/400).
Conclusions:
Postoperative macular hole formation after PPV for VMT is uncommon. FTMHs after PPV for VMT can be successfully repaired with further surgery but visual acuity outcomes are variable.