Eccentric Macular Hole Formation Following Successful Macular Hole Surgery

Abstract

Objective. Postoperative eccentric macular hole for­mation is a rare complication after vitrectomy with in­ternal limiting membrane peeling for a macular hole. We report a rare case of late eccentric macular hole formation following successful macular hole surgery.

Case Report. A 73-year old woman was referred with a long standing full thickness macular hole in both eyes. The patient underwent sequential cataract surgery, 23 gauge sutureless pars plana vitrectomy with internal limiting membrane peeling and inverted flap in both eyes. Control examination six months after the surgery revealed best corrected visual acuity of 20/40 in both eyes, complete closure of the macular hole, with reti­nal atrophy in both eyes. Control examination eighteen months after the surgery revealed a stable finding in the right eye and an eccentric temporal macular hole in the left eye. The patient was closely observed for one year with no signs of visual acuity reduction or macular hole changes.

Conclusion. Postoperative eccentric macular holes may occur after a long follow up period. Most cas­es remain stable for a long period of time and do not re­quire further surgical intervention. This case highlights the need for close monitoring of patients after macular hole surgery with internal limiting membrane peeling.