The results of surgery on macular holes associated with rhegmatogenous retinal detachment.

Abstract

Macular holes can occur as a secondary phenomenon with or after otherwise successful repair of uncomplicated macula-off rhegmatogenous retinal detachments with peripheral breaks. The purpose of this study was to evaluate the anatomical and visual outcomes of vitrectomy surgery to close the macular holes in these situations. A retrospective record review was completed for patients with a retinal detachment with peripheral breaks and a macular hole or those patients developing macular holes within 2 weeks of successful primary external buckling surgery for macula-off retinal detachment. In those patients with a concurrent macular hole and retinal detachment, a primary vitrectomy was carried out to close the macular hole and reattach the retina. In those patients who developed a macular hole after successful primary external buckling surgery, a secondary vitrectomy was then carried out to close the macular hole. The authors reviewed the records of 10 patients. All had a preoperative visual acuity of 20/400 or worse. After surgery, one patient achieved a best-corrected visual acuity of 20/40; six patients achieved a best-corrected visual acuity of 20/80; and three patients achieved a best-corrected visual acuity of 20/120. These results suggest that macular hole surgery is worthwhile for these patients and can provide satisfactory results in terms of visual improvement.