Our Summary

The paper discusses a unique case where a 58-year-old man developed a macular hole (a break in the macula, the part of your eye that provides sharp, central vision) after undergoing a surgery (vitrectomy) to fix a detached retina. Interestingly, this hole was found to be caused by tension (vitreomacular traction) from leftovers of a jelly-like substance (posterior vitreous cortex) in the eye. What’s even more surprising is that the hole closed on its own four weeks after the surgery without any treatment. This is the first time such a case has been reported. The findings suggest that the tension caused by the leftovers of the jelly-like substance plays a significant role in the formation of secondary macular holes.

FAQs

  1. What is a vitrectomy and why is it performed?
  2. What are the possible complications that can occur after a vitrectomy?
  3. What is the significance of the vitreomacular traction and how does it relate to macular hole formation?

Doctor’s Tip

A doctor might advise a patient undergoing vitrectomy to follow post-operative instructions carefully, including avoiding activities that could put strain on the eyes and attending all follow-up appointments to monitor for any potential complications like macular hole formation. It is important to report any changes in vision or symptoms to the doctor promptly.

Suitable For

Patients who may be recommended for vitrectomy include those with rhegmatogenous retinal detachment, macular hole, vitreomacular traction, epiretinal membrane, diabetic retinopathy, macular edema, and other vitreoretinal disorders. In this case report, the patient underwent vitrectomy for rhegmatogenous retinal detachment repair and subsequently developed a macular hole with vitreomacular traction.

Timeline

Before vitrectomy:

  • Patient presents with macula-off superior rhegmatogenous retinal detachment (RRD)
  • Vitrectomy is performed to repair the RRD

After vitrectomy:

  • 2 weeks postoperatively: Macular hole (MH) with vitreomacular traction (VMT) caused by posterior vitreous cortex remnants develops
  • 4 weeks postoperatively: Optical coherence tomography reveals resolution of VMT and spontaneous closure of MH without any treatment provided

What to Ask Your Doctor

  1. What is a vitrectomy and how does it work to repair a retinal detachment?
  2. What are the potential risks and complications associated with vitrectomy surgery?
  3. How common is it for a macular hole to develop after vitrectomy for retinal detachment repair?
  4. What are the symptoms of a macular hole and how is it diagnosed?
  5. Is there a possibility of the macular hole closing on its own without additional treatment?
  6. What is the likelihood of developing any long-term vision problems or complications after the macular hole closes?
  7. Are there any specific post-operative care instructions or precautions I should follow to prevent complications or promote healing?
  8. How soon after surgery should I expect to see improvement in my vision?
  9. Are there any lifestyle changes or adjustments I should consider to protect my eyes and prevent future retinal detachment or macular hole formation?
  10. Are there any follow-up appointments or tests recommended to monitor the healing process and ensure the success of the surgery?

Reference

Authors: Kim JY, Park SP. Journal: Indian J Ophthalmol. 2015 Oct;63(10):791-3. doi: 10.4103/0301-4738.171514. PMID: 26655006