Macular Hole Formation After Pars Plana Vitrectomy for Diabetic Tractional Retinal Detachment

Ophthalmic Surg Lasers Imaging Retina. 2018 Dec 1;49(12):e256-e262. doi: 10.3928/23258160-20181203-16.

Abstract

Background and objective: To investigate the incidence, clinical features, and outcomes of patients with macular hole (MH) formation after pars plana vitrectomy (PPV) for diabetic tractional retinal detachment (TRD).

Patients and methods: We conducted a retrospective review of all cases of PPV for diabetic TRD performed by a surgeon (DS) at a large county hospital between November 2013 and August 2016.

Results: Ninety consecutive eyes of 79 patients were included in this case series, of which four eyes developed MH, yielding an incidence of 4.4% (95% confidence interval [CI], 1.2%-11.0%). The mean interval between PPV for TRD and MH formation was 7.0 ± 5.5 (mean ± 1 standard deviation) months, and mean follow-up time was 29.6 months ± 6.9 months. Three of the four eyes that developed MH underwent intervention, and of the three that underwent intervention, all had successful hole closure.

Conclusion: In this case series, the incidence of MH after PPV for TRD is 4.4% (95% CI, 1.2%-11.0%). The mechanism of MH formation after diabetic TRD repair is not certain but may be related to a taut internal limiting membrane, epiretinal membrane formation, macular edema, or residual vitreous contraction. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e256-e262.].

MeSH terms

  • Adult
  • Aged
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Reoperation
  • Retinal Detachment / diagnosis
  • Retinal Detachment / etiology*
  • Retinal Detachment / surgery
  • Retinal Perforations / diagnosis
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy / adverse effects*
  • Young Adult