title: Surgery for bilateral macular holes.
abstract: OBJECTIVE
  To report on bilateral sequential macular hole repair.
  
  
  METHODS
  Retrospective case series report.
  
  
  METHODS
  Sixteen eyes of eight patients with reduced visual acuity (VA) and metamorphopsia due to bilateral macular hole.
  
  
  METHODS
  Patients underwent vitrectomy surgery for bilateral macular hole. Seven patients had both eyes operated on consecutively at the same operating session. One patient had surgery to the fellow eye the next day. Strict facedown posturing was undertaken for 1 week by all patients.
  
  
  METHODS
  Closure of macular hole; final VA; complications.
  
  
  RESULTS
  In 15 (94%) eyes the macular holes closed with resolution of symptoms; the mean VA at discharge was 6/15; two patients had reduced VA due to age-related macular degeneration (6/36, 6/18); five eyes had entry site tears; there was one case of lens touch with elevated intraocular pressure (IOP); in one (6%) patient the macular hole reopened after later cataract surgery (VA 6/24).
  
  
  CONCLUSIONS
  Surgical closure of bilateral macular holes at the same operating session has distinct advantages but also considerable disadvantages. Case selection is paramount-patients require careful preoperative counselling and postoperative support, especially during the posturing week.
authors.affiliation: Department of Ophthalmology, James Paget University Teaching Hospital, East Anglia, UK. dgupta_01@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Gupta
authors.forename: C
authors.initials: C
authors.lastname: Goldsmith
authors.forename: R L
authors.initials: RL
authors.lastname: Burton
mesh_terms: D000368:Aged; D006801:Humans; D011182:Postoperative Care / Q000379:methods; D011187:Posture; D012167:Retinal Perforations / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*