MACULAR HOLE FORMATION AND CLOSURE AFTER CATARACT EXTRACTION AND Nd:YAG CAPSULOTOMY IN A VITRECTOMIZED EYE WITH AN EPIRETINAL MEMBRANE.
BACKGROUND
Vitreomacular traction and degeneration of the inner retinal layers of the fovea are considered contributing factors to idiopathic macular hole (MH) formation. This case report illustrates a rare scenario of MH formation and spontaneous closure associated with an epiretinal membrane (ERM) and perifoveal cystoid edema without anteroposterior traction from the vitreous in a previously vitrectomized eye.


METHODS
A case report following MH clinical progression with visual acuity and serial optical coherence tomography.


RESULTS
A 47-year-old high myope underwent scleral buckle placement and pars plana vitrectomy for a macula-off, phakic, inferior retinal detachment with a giant retinal tear and proliferative vitreoretinopathy 2.5 years ago with eventual visual acuity of 20/20. Postoperatively, an ERM developed, and uncomplicated phacoemulsification cataract extraction was later performed. One week after Nd:YAG capsulotomy, a full-thickness MH formed (with perifoveal cystoid macular edema) that spontaneously resolved 2 months later with return of vision to 20/20.


CONCLUSIONS
After vitrectomy, anteroposterior vitreofoveal traction no longer contributes to MH formation. Perifoveal cystoid macular edema as well as tangential traction from ERMs may contribute to MH formation.
From the Duke University Eye Center, Duke University Medical Center, Durham, North Carolina.
Felix Y
FY
Chau
Sharon
S
Fekrat