Intraretinal Silicone Oil Infiltration following Traumatic Macular Hole Repair

Matthew Benage Richard Hwang

doi:10.4172/2155-9570.1000442

Abstract

Purpose: To present a case study describing incorporation of silicone oil into a traumatic macular hole following surgical correction. Methods: Case report Results: A nine-year-old male presented with a traumatic macular hole. After waiting for spontaneous closure, pars plana vitrectomy with standard 1000 centistroke silicone oil tamponade was performed. Postoperatively, spectral-domain optical coherence tomography, demonstrated closure of the macular hole, but with infiltration of silicone oil into the foveal architecture. A second surgical approach with different attempts to remove the retained silicone oil's bubble was successfully performed using a soft-tip cannula. However, the macular hole reopened intraoperatively. Therefore silicone oil was replaced with no infiltration and adequate closure of the macular hole. Conclusion: Previous reports have demonstrated small droplets of retained silicone oil within the retinal layers, but to our knowledge, this is the first report of a large globule of oil becoming incorporated into a healing macular hole.

Highlights

Compared to idiopathic macular holes, traumatic macular holes tend to occur in younger patients, present with worse initial vision, and are thought to be related to the transmission of tangential tractional forces on the macula. [1,2]
Once spontaneous resolution is not achieved, pars plana vitrectomy (PPV) with internal limiting membrane peel and endotamponade is typically the treatment of choice, using either gas or silicone oil. Studies have shown both to be successful in anatomic closure of macular holes, with gas showing some advantages in visual acuity[3]
Three weeks post-operatively, the macular hole appeared to be closed on exam under silicone oil, but the patient complained of a large circle in his central vision

Summary

Introduction

Compared to idiopathic macular holes, traumatic macular holes tend to occur in younger patients, present with worse initial vision, and are thought to be related to the transmission of tangential tractional forces on the macula. [1,2]. Once spontaneous resolution is not achieved, pars plana vitrectomy (PPV) with internal limiting membrane peel and endotamponade is typically the treatment of choice, using either gas or silicone oil. Studies have shown both to be successful in anatomic closure of macular holes, with gas showing some advantages in visual acuity[3]. There have been some reports of emulsified oil migrating into the retina across the internal limiting membrane (ILM)[4].

Results

Conclusion