43.
The Mischievous Macular Hole: a Case Series
Paul B. Griggs (Seattle)
Purpose: To review the clinical results of macular vitreoretinal interface surgery with atypical
clinical outcomes.
Methods: Patients were identified in which surgery was performed for macular hole, pucker,
and/or vitreomacular traction. Records were analyzed for Snellen visual acuity, central foveal
thickness on OCT, and fluorescein angiographic characteristics in selected cases. The number
of procedures and period of time over which they were administered was evaluated. The analysis
included the clinical status of each patient at the initiation of therapy and at the time of
data analysis.
Results: The initial evaluation revealed the presence of macular hole, epiretinal membrane,
and/or vitreomacular traction in one or both eyes. Pars plana vitrectomy was performed in all
patients. Posterior vitreous hyaloid separation was confirmed and/or performed in all patients. Epiretinal membrane dissection
was performed when indicated. Internal limiting membrane dissection was performed in all cases of macular hole.
Secondary procedures were performed as clinically indicated.
Conclusion: Vitreoretinal interface abnormalities affecting the macula are one of the most common clinical entities encountered
in the vitreoretinal practice. Surgery for macular hole, pucker, and vitreomacular traction is typically uncomplicated
and results in clinical improvement. Presented herein is a group of patients who underwent uncomplicated surgery and
responded with atypical clinical outcomes.