Macular pucker formation after macular hole surgery with inverted internal limiting membrane flap technique and silicone oil tamponade

American Journal of Ophthalmology Case Reports

Takahiro Kawaji¹  Akiomi Takano²  Akira Hirata³  Kei-ichiro Nakamura⁴ 

[1] Corresponding author. Hayashi Eye Hospital, 4Hakataekimae, Fukuoka, 812, Japan.;Division of Microscopic and Developmental Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan;Hayashi Eye Hospital, Fukuoka, Japan;Takano Eye Clinic, Kumamoto, Japan;

关键词: Macular hole;    Vitrectomy;    Internal limiting membrane;    Silicone oil;    FIB/SEM;   

DOI  :  

来源: DOAJ

【 摘 要 】

Purpose: The inverted internal limiting membrane (ILM) technique was recently introduced for refractory macular hole. Here, we evaluate a case of macular pucker formation after macular hole surgery using the inverted ILM flap technique and silicone oil tamponade. After undergoing vitrectomy combined with ILM removal, the patient had a good visual prognosis. Observations: A 49-year-old male with macular hole affecting both of his eyes underwent vitrectomies. Three months after the first surgery in his right eye, macular pucker formation was observed in the macula, which was associated with the ILM flap used to cover the macular hole. After peeling the ILM, the macula returned to a normal contour and visual acuity improved. Examination of the removed ILM revealed macrophage-like cells containing silicone oil particles that were responsible for the ILM contraction. Conclusions and Importance: When using the inverted ILM flap technique and silicone oil, macular pucker may occur after macular hole surgery. Peeling of the ILM flap restored the macular shape and did not reopen the macular hole, thereby improving visual acuity. Thus, silicone oil should be used with caution when performing macular hole surgery with the ILM flap technique.

【 授权许可】

Unknown