Failed macular hole surgery: What to do?

Poster Details

First Author: M.De Alba Castilla MEXICO

Co Author(s):    J. Ruiz Gonzalez   Y. Bages Rousselon   J. Davila Villarreal   H. Trevino Rodriguez   C. Azuara Azuara   J. Gonzalez Cortes              

Abstract Details


Currently the most accepted surgical management of macular holes (MH) involves pars plana vitrectomy with removal of the internal limiting membrane (ILM). However, macular holes may persist after surgery. The purpose of this poster is to show a different approach for failed macular hole surgery.


Departamento de Oftalmología, Hospital Universitario, Facultad de Medicina. UANL. Monterrey, Nuevo León, México.


This is a retrospective review of consecutive cases to evaluate the outcome of reintervention after initial failed surgery for macular hole with removal of ILM. All cases underwent ILM removal during the first surgery, this was corroborated with preservative-free triamcinolone acetonide and/or brilliant blue during the second procedure and extended if necessary, as well as passive aspiration with silicon-tipped 25 g cannula of the MH under heavy perfluorocarbon liquid.


Mean MH initial diameter was 934µm (± 304.14) and before reintervention 873µm (± 344.14). Anatomical closure was acheived in 57.1% of cases after second surgery. There was no significant difference in best corrected visual acuity (BCVA) between initial and second surgery.


The decision to intervene a persistent MH needs to take into account several factors: MH diameter, BCVA and time between interventions. Nonetheless, even in cases with previous vitrectomy with ILM removal reintervention may achieve MH closure.

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