J Korean Ophthalmol Soc.  2012 Apr;53(4):597-601.

A Case of Secondary Macular Hole Formation after Phacoemulsification in a Vitrectomized Eye

• Yun CM
• Yang SM
• Kim SW
• Oh JR
• Huh K

Abstract

PURPOSE
To report a case of secondary macular hole formed after phacoemulsification in a vitrectomized eye which was treated with macular hole surgery.
CASE SUMMARY
A 53-year-old man with a history of pars plana vitrectomy developed a cataract in his left eye. Uncomplicated cataract surgery involving phacoemulsification with posterior chamber intraocular lens implantation was performed. At his routine 3-month post-operative visit, he reported metamorphopsia. Fundus examinations and optical coherence tomography revealed a cystoid macular edema and a full thickness macular hole. He underwent repair of the macular hole including internal limiting membrane peeling and gas injection. Three months later, post-operative examinations showed anatomical closure of the macular hole.
CONCLUSIONS
When performing cataract surgery, even in a previously vitrectomized eye, clinicians should be aware of the possibility of cystoid macular edema. A thorough pre- and post-operative assessment, including fundus examinations and optical coherence tomography must be carefully performed in order to detect a macular hole associated with cystoid macular edema. And prompt treatment is required when a macular hole is detected.

Keyword

Cataract surgery; Cystoid macular edema; Macular hole; Vitrectomized eye

MeSH Terms

Cataract
Eye
Humans
Lens Implantation, Intraocular
Macular Edema
Membranes
Middle Aged
Phacoemulsification
Retinal Perforations
Tomography, Optical Coherence
Vision Disorders
Vitrectomy

Figure

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  Figure 1 Optical coherence tomography before cataract surgery does not show macular edema.

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  Figure 2 Fundus photography (A) and fluorescein angiography (B, C) at 3 months after cataract surgery shows macular hole and cystoid macula edema.

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  Figure 3 Optical coherence tomography shows full thickness macular hole 3 months after cataract surgery.

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  Figure 4 Optical coherence tomography shows closed macular hole with subretinal fluid 3 months after ILM peeling and C3F8 (14%) gas tamponade.

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