Abstract

BackgroundFull-thickness macular hole (FTMH) is a rare complication in retinitis pigmentosa (RP) patients and may increase intraoperative challenges. Furthermore, lens capsular flap transplantation and inverted internal limiting membrane (ILM) flap were reported to close complicated FTMH successfully. Here, we present a case of bilateral advanced RP complicated by a FTMH treated with a novel lens capsular flap transplantation and inverted internal limiting membrane flap.Case presentationA 46-year-old presented to our hospital with a complaint of progressively blurred vision and metamorphopsia in both eyes. Spectral-domain optical coherence tomography revealed a FTMH with retinoschisis in the right eye and another FTMH in the left eye. ILM peeling with inverted ILM flap technique was performed on the right eye and ILM peeling with anterior lens capsular flap technique was performed on the left eye. Post-operative follow-up showed successful closure of the FTMH and improved vision in both eyes.ConclusionsIn our present case, flap-assisted techniques for retinitis pigmentosa with macular hole result in excellent visual and anatomic outcomes.

Highlights

  • Full-thickness macular hole (FTMH) is a rare complication in retinitis pigmentosa (RP) patients and may increase intraoperative challenges

  • Dysfunction of the retinal pigment epithelium (RPE) in RP may lead to a failure of the pumping mechanism, causing hydration of the foveolar with progressive enlargement of the hole

  • Electroretinography showed diminished waves, both in rods and cones, in both eyes. In his right eye with cataract, FTMH, and retinoschisis, 25-gauge pars plana vitrectomy, end of the article membrane (ERM)/internal limiting membrane (ILM) peeling with inverted ERM/ILM flap technique, and C3F8 gas tamponade were performed combined with phacoemulsification and posterior chamber intraocular lens implantation under retrobulbar anesthesia

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Summary

Conclusions

Flap-assisted techniques for retinitis pigmentosa with macular hole result in excellent visual and anatomic outcomes.

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