Macular hole closure at seven years after surgery

Abstract

Purpose To report a case of macular hole (MH) closure at seven years after internal limiting membrane (ILM) peeling. Observations A 66-year-old woman developed a MH in her left eye. Pars plana vitrectomy with ILM peeling and SF6 gas injection followed by face-down position for a week slightly improved the visual acuity from 20/400 to 20/200 but did not close the MH. During subsequent three years of follow-up without any treatment, the MH did not close. Seven years after the surgery, she visited us for cataract surgery in her right eye, and the optical coherence tomography (OCT) examination coincidentally found closure of the MH in her left eye. The visual acuity of her left eye remained 20/200 despite the MH closure. Conclusions and Importance ILM peeling might indirectly contribute to the closure of MH at seven years after the surgery although the mechanism is unclear. Sharing the serial OCT images until the MH closure would help us explore the mechanisms of ILM peeling to close MH and develop rational surgery technique manipulating ILM for MH.

Rhegmatogenous Retinal Detachment With Concurrent Choroidal Detachment and Macular Hole Formation After Uncomplicated Cataract Extraction and Intraocular Lens Implantation: A Case Report and Review of Literature

“…Delayed macular closure is uncommon after pars plana vitrectomy with ILM peeling but has been previously reported as late as 4 years to 7 years postoperatively. 8 The exact mechanism for this phenomenon remains unclear; however, increased retinal tissue elasticity after ILM removal has been implicated. 8 In the study by Gui et al, three patients had RRD for seven days or less, with five patients who had a duration of RRD of 10 days to 30 days.…”

“…8 The exact mechanism for this phenomenon remains unclear; however, increased retinal tissue elasticity after ILM removal has been implicated. 8 In the study by Gui et al, three patients had RRD for seven days or less, with five patients who had a duration of RRD of 10 days to 30 days. Final VA was mixed with no clear trend based on the timing of surgery.…”

“…8 The exact mechanism for this phenomenon remains unclear; however, increased retinal tissue elasticity after ILM removal has been implicated. 8…”