The behavior of surgically repaired idiopathic macular holes in the setting of subsequent cystoid macular edema.

Abstract

To report findings for eyes with surgically repaired idiopathic macular hole that subsequently developed cystoid macular edema (CME). This study was a retrospective chart review of six eyes of six consecutive patients evaluated between January 1997 and October 2000 who had successful macular hole repair and subsequently developed CME. Patient demographic data, cause and time course of CME, treatment, and outcomes, including macular hole reopening, were recorded. CME developed after cataract extraction in five eyes and after macular hole surgery alone in one eye. Average time from macular hole surgery to diagnosis of CME was 11.2 months (range, 2.5-23.0 months). Average duration of CME was 5.5 months (range, 1.5-17.0 months). Five (83%) of 6 eyes had sustained closure of the macular hole throughout a mean follow-up period of 31.8 months (range, 9.5-62.0 months). Patients were treated with topical antiinflammatory therapy, and all had resolution of CME. CME developing in eyes with surgically repaired idiopathic macular holes responds well to conventional topical antiinflammatory therapy and is not associated with a high incidence of macular hole reopening. These results suggest that in most eyes the reparative mechanisms involved in macular hole closure confer sufficient strength to withstand the tensile forces associated with CME.