J Korean Ophthalmol Soc.  2013 Apr;54(4):686-690. 10.3341/jkos.2013.54.4.686.

Delayed Sealing of Macular Hole after Vitrectomy with Silicone Oil Tamponade

• Choi YM
• Oh J
• Kim SW
• Huh K

• KMID: 2216956
• DOI: http://doi.org/10.3341/jkos.2013.54.4.686

Abstract

PURPOSE
To report a case of delayed sealing of full-thickness macular hole associated with diabetic retinopathy after vitrectomy with silicone oil tamponade.
CASE SUMMARY
A 63-year-old woman visited our clinic complaining of decreased visual acuity in her left eye. Fundoscopy showed a full-thickness macular hole with vitreomacular traction in the left eye and bilateral proliferative diabetic retinopathy. The patient underwent uncomplicated phacoemulsification and pars plana vitrectomy with silicone oil tamponade because her vision in the contralateral eye was only light perception. She was unable to maintain a prone position postoperatively due to anterior chamber hyphema. At 1.5 months after surgery, vitreomacular traction was removed but the hole was not sealed as observed on optical coherence tomography. Approximately 3 months after vitrectomy, the macular hole was sealed with minimal subfoveal fluid. At 6 months after vitrectomy, the macular hole was closed completely with no subfoveal fluid.

Keyword

Delayed sealing; Macular hole; Silicone oil tamponade

MeSH Terms

Anterior Chamber
Diabetic Retinopathy
Eye
Female
Humans
Hyphema
Light
Phacoemulsification
Prone Position
Retinal Perforations
Silicone Oils
Tomography, Optical Coherence
Traction
Vision, Ocular
Visual Acuity
Vitrectomy
Silicone Oils

Figure

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  Figure 1. Preoperative macular optical coherence tomography and fundus photography (top row) shows a full-thickness macular hole with vitreomacular traction. Macular thickness map (top middle) revealed macular and perimacular thickening. At 1.5 months after vitrectomy and silicone oil tamponade (second row), vitreomacular traction was removed. However, macular hole was not closed. Perimacular thickening is observed on the macular thickness map. At 3 months after the surgery (third row), macular hole was closed with minimal subfoveal fluid. Reduced perimacular thickening was observed. At 6 months postoperatively (bottom row), subfoveal fluid was completely absorbed and perimacular thickening was further reduced.

Reference

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