Eccentric macular holes after vitrectomy with peeling of epimacular proliferation.
OBJECTIVE
To describe six patients (six eyes) who developed an eccentric macular hole after surgery for idiopathic epimacular proliferation.


METHODS
In a retrospective review of 631 consecutive patients who underwent vitrectomy with peeling of the epimacular proliferation and in most cases the internal limiting membrane (ILM) from May 2001 to May 2005, 6 patients were found to have developed an eccentric macular hole postoperatively.


RESULTS
Eccentric macular holes developed 9 days to 8 months (mean, 3.1 months) after epimacular proliferation peeling. The ILM was peeled in addition to the epimacular proliferation in five of the six cases. Of the six eccentric macular holes, four were located temporal to the fovea, one was located superior to the fovea, and one was located nasal to the fovea. Final visual acuities after a mean follow-up period of 17.3 months were 20/20 in 2 eyes, 20/25 in 1 eye, 20/40 in 2 eyes, and 5/200 in 1 eye. The eye with the eccentric macular hole nasal to the fovea had the poorest final visual acuity of 5/200.


CONCLUSIONS
Eccentric macular hole occurring after vitrectomy to remove epimacular proliferation is an uncommon postoperative finding. To our knowledge, this is the largest case series of such patients reported. Various explanations have been suggested for the etiology of these holes, but there remains no consensus.
Mason
John O
JO
Retina Consultants of Alabama, P.C., Department of Ophthalmology, University of Alabama at Birmingham, 35233, USA. mikealbert1@msn.com
Feist
Richard M
RM
Albert
Michael A
MA
D000328:Adult; D000368:Aged; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000601:surgery; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000009:adverse effects*