SECONDARY FULL THICKNESS MACULAR HOLES FOLLOWING COMPLETE VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT: Rare Occurrence With Good Closure Rate.

Abstract

Formation of a full thickness macular hole (FTMH) after vitrectomy is rare. The aim of this study was to describe risk factors, clinical course, anatomical and functional prognosis of secondary FTMH development following surgery for primary rhegmatogenous retinal detachment. This is a retrospective study. Eyes treated for rhegmatogenous retinal detachment at two centers between January 2012 and December 2022 were screened and those that developed secondary FTMH after pars plana vitrectomy without membrane peeling were included in our analysis. Twenty-nine eyes (mean age 58.9 ± 9.5 years, 51.7% female) of 5,219 eyes developed secondary FTMH following pars plana vitrectomy for retinal detachment, equaling a rate of 0.56%. Median interval between vitrectomy and FTMH diagnosis was 14.0 months (Q1 2.0; Q3 61.0; range 1-373). Full thickness macular hole was treated by re-pars plana vitrectomy, Internal limiting membrane peeling, sulfur hexafluoride (SF6 20%-25%) endotamponade in 22, silicone oil in 6, and heavy silicone oil in one eye. In 88.0% FTMH, closure was observed after surgery. Postoperative mean visual acuity of all eyes was 20/145 Snellen (0.86 ± 0.76 logarithm of minimum angle of resolution) versus preoperative 20/215 (1.03 ± 0.43; P < 0.001). Secondary FTMH after rhegmatogenous retinal detachment repair is a rare occurrence complication and can often be successfully treated by re-pars plana vitrectomy. Visual acuity improves following successful hole closure but less than that in primary FTMHs.