Purpose: Regarding the treatment strategy for macular holes (MHs) associated with rhegmatogenous retinal detachment (RRD) detected for the first time using intraoperative optical coherence tomography (OCT) during vitrectomy, it is unclear whether internal limiting membrane (ILM) peeling should be used in combination. Moreover, only a few studies have reported the outcomes of this treatment. Therefore, this study aimed to investigate the outcome of vitrectomy without ILM peeling in patients diagnosed with MH associated with RRD for the first time using intraoperative OCT.
Subjects and methods: Among 78 patients with RRD who underwent vitrectomy at Yamagata University Hospital from November 2018 to July 2019, we retrospectively examined 4 eyes of 4 male patients with evident peripheral retinal tears (mean age, 62.8±1.7 years). Intraoperative OCT confirmed the presence of MH for the first time in these patients, after which the subretinal fluid was drained through the peripheral retinal tear without ILM peeling. During surgery, air or gas was used as the tamponade agent. After surgery, the patients were instructed to maintain a prone position until postoperative intraocular tamponade declined to 50%.
Results: Intraoperative OCT detected a mean diameter of 277.7±67.0 μm for MH. After the initial surgery, OCT revealed MH closure in 4 eyes of the 4 patients (100%) on average 8.3±2.9 days later.
Conclusion: In MH associated with RRD, hole closure can be achieved with conventional vitrectomy and air or gas tamponade without ILM peeling.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 96-102, 2024.