title: Full-Thickness Macular Hole Secondary to High-Power Handheld Blue Laser: Natural History and Management Outcomes.
abstract: OBJECTIVE
  To report the natural history and management outcomes of full-thickness macular hole (MH) caused by momentary exposure to a high-power handheld blue laser device and highlight the dangers of such easily available devices.
  
  
  METHODS
  Retrospective consecutive case series.
  
  
  METHODS
  A chart review of all patients presenting with full-thickness MH from exposure to blue-light high-powered lasers from January 2012 to May 2014 at 2 institutions was performed. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography. The main and secondary outcomes were MH closure and final visual acuity, respectively.
  
  
  RESULTS
  There were 17 eyes of 17 patients with full-thickness MH. Best-corrected Snellen visual acuity (BCVA) at presentation ranged from 20/30 to 2/200 (mean: 20/210). The MH minimum diameter ranged from 168 μm to 620 μm (mean: 351 μm). Fourteen eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas or silicone oil tamponade. Eleven of the 14 (78.6%) operated eyes had complete closure of the macular hole. Of the 3 unoperated eyes, only 1 eye with the smallest macular hole (minimum diameter: 168 μm) closed spontaneously with observation. Final BCVA in all cases had a mean of 20/62 (range: 20/20-4/200).
  
  
  CONCLUSIONS
  Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Sulaiman M
authors.initials: SM
authors.lastname: Alsulaiman
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Abdulaziz Adel
authors.initials: AA
authors.lastname: Alrushood
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Jluwi
authors.initials: J
authors.lastname: Almasaud
authors.affiliation: Vitreoretinal Division, Department of Ophthalmology, King Saud University, College of Medicine, Riyadh, Saudi Arabia.
authors.forename: Abdullah S
authors.initials: AS
authors.lastname: Alkharashi
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Alzahrani
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Emad B
authors.initials: EB
authors.lastname: Abboud
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Sawsan R
authors.initials: SR
authors.lastname: Nowilaty
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arevalo
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al-Amry
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Saba
authors.initials: S
authors.lastname: Alrashaed
authors.affiliation: Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, University of Virginia Health System, Charlottesville, Virginia. Electronic address: nicola.ghazi@gmail.com.
authors.forename: Nicola G
authors.initials: NG
authors.lastname: Ghazi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000601:surgery; D005131:Eye Injuries / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007834:Lasers / Q000009:adverse effects*; D008297:Male; D016684:Prone Position; D012160:Retina / Q000293:injuries*; D012167:Retinal Perforations / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren; D013459:Sulfur Hexafluoride