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Br J Ophthalmol. 2008 Feb;92(2):217-9. doi: 10.1136/bjo.2007.122796.

Results of surgery on macular holes that develop after rhegmatogenous retinal detachment.

Author information

  • 1Department of Ophthalmology, 1 rue Germont, Charles Nicolle University Hospital, 76000 Rouen, France. mounir.benzerroug@free.fr

Abstract

AIMS:

To evaluate the characterics and surgical prognosis of macular holes that develop after rhegmatogenous retinal detachment repair.

DESIGN:

Retrospective, interventional, consecutive case series.

METHODS:

The case records of nine patients who developed a new full-thickness macular hole after prior RD repair were reviewed over 6 years. Optical coherence tomography (OCT) confirmed these holes. They were offered surgical repair with a median follow-up of 13.3 months (1-63 months). Main outcomes included preoperative vitreo-macular status, OCT evaluation and postoperative visual acuity.

RESULTS:

1007 eyes underwent surgery for prior retinal detachment between August 1999 and September 2005. Nine eyes developed a full-thickness macular hole (prevalence 0.9%): five developed after scleral buckling surgery, one after pneumatic retinopexy and three after primary vitrectomy. The mean time to macular hole diagnosis after RD was 2.9 months (0.5-18). All patients underwent macular hole surgery by the same surgeon. At 1 month, macular hole repair was noticed in eight eyes. In this group, visual acuity at a median of 11.9 months of follow-up was 20/125 (20/400 - 20/63). Three eyes had an improvement of more than three Snellen lines.

CONCLUSIONS:

Macular holes developing after RD repair is a rare complication (less than 1%). Its physiopathological mechanisms are not well known. Conventional macular hole surgery including pars plana vitrectomy, inconstant internal limiting membrane delamination and long-acting gas tamponade seems to achieve to macular reattachment (89%). The visual outcome seems conditioned by the macular status noticed during the RD.

PMID:
18227202
[PubMed - indexed for MEDLINE]
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