Postoperative eccentric macular holes after vitrectomy and internal limiting membrane peeling

International Ophthalmology - Tập 37 - Trang 643-648 - 2016
Dimitrios Brouzas1, Maria Dettoraki1, Anastasios Lavaris1, Dimitrios Kourvetaris1, Nikolaos Nomikarios1, Marilita M. Moschos1
1Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece

Tóm tắt

The purpose of this study was to describe the incidence, clinical characteristics, and outcome of eccentric macular holes presenting after vitrectomy and internal limiting membrane (ILM) peeling for the treatment of macular pathology and discuss the pathogenesis of holes formation. A retrospective, noncomparative, interventional case-series study of five patients who developed eccentric macular holes postoperatively following vitrectomy in 198 consecutive patients who underwent ILM peeling for idiopathic macular hole and epiretinal membrane formation between 2008 and 2015. Five patients (2.5 %) developed full-thickness eccentric macular holes postoperatively. Three patients presented with a single eccentric macular hole, one patient had an eccentric hole after a failed idiopathic macular hole surgery and one patient developed four eccentric macular holes. The mean diameter of the holes was 584 μm (range 206–1317 μm) and the average time of holes formation after vitrectomy was 27.7 weeks (range 1–140 weeks). Postoperative best-corrected visual acuity ranged from “counting fingers” to 20/25. The eyes with the holes distant from the fovea had the best final visual acuity. No further intervention was attempted and no complications occurred. The mean follow-up time was 26.8 months. The postoperative macular holes after vitrectomy and ILM peeling were variable in number, size, and time of appearance but remained stable and were not associated with any complications. The pathogenesis of macular holes is most consistent with contraction of the residual ILM or secondary epimacular proliferation probably stimulated by ILM peeling.

Tài liệu tham khảo

Rubinstein A, Bates R, Benjamin L, Shaikh A (2005) Iatrogenic eccentric full thickness macular holes following vitrectomy with ILM peeling for idiopathic macular holes. Eye 19:1333–1335 Steven P, Laqua H, Wong D, Hoerauf H (2006) Secondary paracentral retinal holes following internal limiting membrane removal. Br J Ophthalmol 90:293–295 Mason JO III, Feist RM, Albert MA Jr (2007) Eccentric macular holes after vitrectomy with peeling of epimacular proliferation. Retina 27:45–48 Sandali O, El Sanharawi M, Basli E et al (2012) Paracentral retinal holes occurring after macular surgery: incidence, clinical features, and evolution. Graefes Arch Clin Exp Ophthalmol 250:1137–1142 Rush RB, Simunovic MP, Aragon AV II, Ysasaga JE (2014) Postoperative macular hole formation after vitrectomy with internal limiting membrane peeling for the treatment of epiretinal membrane. Retina 34:890–896 Yeh S, Bourgeois KA, Benz MS (2007) Full-thickness eccentric macular hole following vitrectomy with internal limiting membrane peeling. Ophthalmic Surg Lasers Imaging 38:59–60 Kozak I, Freeman WR (2006) Nonprogressive extrafoveal retinal hole after foveal epiretinal membrane removal. Am J Ophthalmol 141:769–771 Wolf S, Schnurbusch U, Wiedemann P et al (2004) Peeling of the basal membrane in the human retina: ultrastructural effects. Ophthalmology 111:238–243 Querques G, Prascina F, Iaculli C, Noci ND (2008) Retinal toxicity of indocyanine green. Int Ophthalmol 28:115–118 Karayanan R, Kenney MC, Kamjoo S et al (2005) Toxicity of indocyanine green (ICG) in combination with light on retinal pigment epithelial cells and neurosensory retinal cells. Curr Eye Res 30:471–478 Uemoto R, Yamamoto S, Takeuchi S (2004) Epimacular proliferative response following internal limiting membrane peeling for idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 242:177–180