Exudative retinal detachment in macular hole surgery using platelet concentrates--a case report.
BACKGROUND
Retinal detachment after macular hole surgery is a rare complication, usually occurring because of small, peripheral holes. We present a patient with a high bullous exudative retinal detachment following pars plana vitrectomy.


METHODS
A healthy 69-year-old patient presented with a macular hole stage III of the left eye. Corrected visual acuity was 20/200. Pars plana vitrectomy was performed without peeling of the internal limiting membrane or an epiretinal membrane, a few drops of platelet concentrate were instilled onto the hole, and the bulbus was filled subtotally with a non-expanding SF6/air mixture. On the 3rd postoperative day a small retinal detachment of the inferior half of the retina was noticed that increased over the next 3 days until it reached the inferior vascular arcade. During the following 3 days a spontaneous remission occurred with complete reattachment of the retina. Six weeks after operation the retina was completely reattached, the macular hole was closed, and the visual acuity was 20/200 with a slight cataract.


CONCLUSIONS
Retinal detachments after macular hole surgery are not always of rhegmatogenous nature but may also be exudative and related to an inflammatory reaction caused by adjuvants. When a retinal detachment occurs immediately after macular hole surgery without detectable holes it may be advisable to wait for some days before reoperation.
Gamulescu
M A
MA
Department of Ophthalmology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany. andreea.gamulescu@klinik.uni-regensburg.de
Roider
J
J
Gabel
V P
VP
D000368:Aged; D001792:Blood Platelets; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000503:physiopathology; D016684:Prone Position; D012075:Remission, Spontaneous; D012163:Retinal Detachment / Q000209:etiology* / Q000503:physiopathology; D012167:Retinal Perforations / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy