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Full-thickness macular holes after surgical repair of primary rhegmatogenous retinal detachments: incidence, clinical characteristics, and outcomes

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Full-thickness macular hole (FTMH) formation following rhegmatogenous retinal detachment (RRD) repair may limit post-operative visual acuity and often requires a return to the operating room, but little is known about this phenomenon.

Methods

This study included all patients with a FTMH that developed after RRD repair from January 1, 2015–July 31, 2020. The main outcome was the rate of FTMH formation following RRD repair as well as characteristics of FTMH following RRD repair that spontaneously close.

Results

There were 470 eyes with a diagnosis of both a FTMH and a RRD during the study period. Of these, 27 (0.28%) developed a FTMH following RRD repair. The median time to FTMH diagnosis was 91 days (25th, 75th quartiles 40, 204 days). The mean minimum hole diameter was 514.5 ± 303.6 microns. There were 4 FTMHs (14.8%) that spontaneously closed without surgical intervention. The spontaneous closure was noted from 4 to 12 weeks after the initial diagnosis of the FTMH. These holes were smaller than the holes that did not close spontaneously (mean minimum diameter 161.8 ± 85.2 vs 588.7 ± 279.3 microns, p = 0.0058). Of the 27 post-operative FTMHs, there were 23 eyes (85%) that underwent surgical intervention with pars plana vitrectomy and internal limiting membrane peeling. Nineteen eyes (83%) closed with one surgery, 20 eyes (87%) ultimately closed, while 3 eyes (11.1%) did not close.

Conclusions

FTMH is relatively uncommon to occur following RRD repair with a prevalence of 0.28% in our series with 87% of these holes achieving closure following surgery or spontaneously. Approximately 15% of FTMHs following RRD repair closed spontaneously and these holes were significantly smaller.

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Authors and Affiliations

  1. The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, 840 Walnut St. Suite 1020, Philadelphia, PA, 19107, USA

    Matthew R. Starr, Raziyeh Mahmoudzadeh, Mirataollah Salabati, Ajay E. Kuriyan, Carl D. Regillo, Jason Hsu, Yoshihiro Yonekawa & Omesh P. Gupta

  2. Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Crystal Lee & Diego Arias

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  1. Matthew R. Starr
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Correspondence to Omesh P. Gupta.

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Ethics approval

This study received approval from Wills Eye Hospital institutional review board and adhered to the tenets of the Declaration of Helsinki.

Competing interests

Consultant for Alcon (O.G., Y.Y., C.D.R.), Stockholder in Aldeyra Therapeutics (C.D.R.), Consultant for Allergan, Bausch + Lomb, Genentech/Roche, Optos, Recens Medical, Regeneron, Spark Therapeutics (A.E.K.).

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Starr, M.R., Lee, C., Arias, D. et al. Full-thickness macular holes after surgical repair of primary rhegmatogenous retinal detachments: incidence, clinical characteristics, and outcomes. Graefes Arch Clin Exp Ophthalmol 259, 3305–3310 (2021). https://doi.org/10.1007/s00417-021-05282-1

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  • DOI: https://doi.org/10.1007/s00417-021-05282-1

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