First Author: O.Okonkwo NIGERIA
Co Author(s): A. Hassan O. Oderinlo 0 0 0 0 0 0 0 0 0
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To present the findings in 3 eyes of 3 patients who underwent macular hole surgery with successful hole closure, but developed macular edema post operatively.
The 3 eyes of 3 patients had macular hole surgery at the Eye Foundation Retina Institute.
A case series of 3 eyes of 3 patients who underwent uneventful macular hole surgery and subsequently developed macular edema. This is not a common complication of surgery. There were 3 females and 1 male. All patients had stage 4 macular holes. All had a standard vitrectomy with dye assisted ILM peel. ICG was used in one patient and BBG was used in the other 2 patients. SF6 18% was used in 2 patients and silicon oil was used in one patient. Post operative OCT was done after tamponading silicon oil removal in one case and after complete disappearance of gas from the eye in the other 2 cases. Of the 2 gas patients, a strict ‘face down position instruction’ compliance was poor in one of the patients.
The post operative OCT while confirming closure of the macular hole, revealed the presence of significant cleft between the neurosenory retina and RPE. There where also intraretinal cystic changes, more prominent in one of the patients who had the silicon oil tamponade. The patient with the poor compliance to face done position had the highest central macular thickness of 496. Visual acuity was essentially unchanged compared to pre operative vision in 2 eyes and deteriorated in 1 eye.
Significant macular edema can be observed as a complication of surgery for stage 4 macular holes. The mechanism for this is unclear, but could be related to post operative inflammation, photoreaction and possibly induced traction from epiretinal membrane. The occurrence of post operative edema could limit visual recovery following macular hole surgery