Reopening of macular holes after initially successful repair

Ophthalmology. 1998 Oct;105(10):1835-8. doi: 10.1016/S0161-6420(98)91025-9.

Abstract

Objective: To evaluate the frequency and prognosis of reopening of a macular hole after initially successful repair in a defined patient cohort.

Design: Retrospective consecutive noncomparative case series.

Participants: Seventeen cases of reopened macular holes among 390 cases of idiopathic macular holes that previously had undergone macular hole surgery were studied.

Main outcome measures: Assessment of demographics, visual acuity, preoperatively, postoperatively, after reopening of macular hole and after reoperation, if applicable, and precipitating factors.

Results: There were 17 (4.8%) of 353 cases in which the macular hole reopened after initial successful surgical closure. The mean visual acuity before reopening was 20/48 and was 20/133 after reopening. Twelve eyes underwent reoperation with improvement to a mean visual acuity of 20/54. The five eyes that were not reoperated on maintained a mean visual acuity of 20/200. Ten of the eyes had undergone cataract surgery between macular hole surgeries, but in only one did the reopening appear to occur in association with this procedure.

Conclusions: Reopening of a previously successfully operated macular hole is uncommon and seems to be a spontaneous event. Reoperation generally yields results similar to those present before the reopening. Reopening of a macular hole associated with cataract surgery is rare.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence
  • Reoperation
  • Retinal Perforations / diagnosis
  • Retinal Perforations / etiology*
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Risk Factors
  • Transforming Growth Factor beta / therapeutic use
  • Visual Acuity
  • Vitrectomy

Substances

  • Transforming Growth Factor beta