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Fusae Kajita, Toshiyuki Oshitari, Mamiko Shibata, Takayuki Baba, Eiju Sato, Shuichi Yamamoto; Development Of Macular Hole After Rhegmatogenous Retinal Detachment Repair: Retrospective Interventional Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6138.
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To determine the factors significantly associated with the development of a macular hole (MH) after successful rhegmatogenous retinal detachment (RRD) surgery.
The medical records of 4 cases from our hospital and one case from another hospital that undergone RRD surgery and later developed a MH were reviewed. The intraoperative information, the interval between the RRD surgery and the development of MH, and optical coherence tomography (OCT) images were examined. The patients were divided into those who had scleral buckling (SB) alone, pars plana vitrectomy (PPV) alone, or PPV with SB.
There were 1260 eyes that underwent surgery for RRD between April 2005 and March 2010 in our hospital. Of these, 837 eyes underwent PPV with or without SB and 423 eyes underwent SB alone. One case was referred to our hospital who had undergone PPV for a RRD at another hospital. Four eyes in our hospital developed a full-thickness MH after the RRD surgery (prevalence 0.32%). The four cases that developed a MH had had PPV alone and one case had PPV with SB. The mean interval between the surgery and the development of a MH was 25.0 months (ranges, 0.27 to 65 months). In all cases, the MHs were closed by PPV with internal limiting membrane (ILM) removal and intraocular gas tamponade. After including the results of three earlier reports published from 2008 in Europe and Japan, the mean interval for the MH to develop after SB alone was significantly shorter than after PPV alone or after PPV with SB.
The development of MH after RRD repair is very rare. The existence of anteroposterior vitreofoveal and tangential traction is not essential for the MH to develop. Our results suggest that the SB procedures might enhance the probability of developing a MH after RRD surgery.
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