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Y. Shimoda, S. Kishi; Full-Thickness Macular Hole After Vitrectomy for Pit-Macular Syndrome. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4713.
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Pit-macular syndrome (PMS) consists of retinoschisis between optic pit and macula, outer macular hole and subfoveal detachment. We report 3 cases with PMS which developed macular hole after vitrectomy.
We treated 11 eyes of PMS with vitrectomy and gas tamponade from September 1997 to June 2007. Internal limiting membrane(ILM) peeling was performed in 7 eyes. After surgery, 3 eyes (30%) developed full thickness macular hole. Two of the 3 eyes underwent ILM peeing.
Two eyes with ILM peeling obtained closure of macular hole after one or twice fluid-gas (30%SF6) exchange. In one eye without ILM peeling, the hole did not close after fluid-gas exchange. We performed second vitrectomy with ILM peeling and gas tamponade and macular hole was finally closed. These 3 eyes obtained foveal retinal attachment and visual improvement with more than 2 lines.
PMS usually has an outer macular hole with overlying thin retina. Thus macular hole may develop after vitrectomy. Macular hole may close by fluid-gas exchange in eyes with ILM peeling but second vitrectomy with ILM peeling is necessary in eyes without ILM peeling at first vitrectomy.
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