Spontaneous Resolution of Retinal Detachment Occurring After Macular Hole Surgery

Abstract

To document the spontaneous resolution of retinal detachment developing after macular hole surgery. Methods: We identified all patients who developed a postoperative retinal detachment after undergoing macular hole surgery at Washington University School of Medicine, St Louis, Mo; the surgery was performed by one of us (L.V.D.P. or H.J.K.) between 1991 and 1996. Results: Six of 73 eyes developed a postoperative retinal detachment; the retinal detachment was inferior in all cases. Two eyes that had inferior retinal breaks underwent further surgery to repair the retinal detachment. Retinal breaks could not be identified in the other 4 eyes; the retinal detachment resolved without further surgery in all 4 of these eyes. Conclusion: The recognition that retinal detachment occurring after macular hole surgery can resolve without additional surgery may result in the avoidance of further surgical intervention in some eyes.

Exudative retinal detachment in macular hole surgery using platelet concentrates – a case report

“…Akduman et al reported in 1998 on four patients with spontaneous resolution of retinal detachment after macular hole surgery [2]. In two cases there was no use of adjuvants during the operation, the detachments occurring 10 days and 2 weeks after surgery respectively and resolving within 3 weeks.…”

Prophylactic scleral buckle for prevention of retinal detachment following vitrectomy for macular hole

“…All four were suspected to be serous in nature and resolved spontaneously without medical or surgical intervention 20. Considering this, an unbiased observer re-examined the operative reports and charts of our detached patients.…”

Delayed exudative subfoveal retinal detachment following successful macular hole surgery

“…2,3 RPE tears may also occur spontaneously after laser photocoagulation or photodynamic therapy for neovascular AMD. 4 We describe a patient who experienced an RPE tear associated with development of choroidal folds after intravitreal bevacizumab injection.…”

“…5 The subfoveal location of the retinal detachment in our case appears to be a unique feature rather than a peripheral involvement as in the previously reported cases. [1][2][3][4][5] Our case is distinguished by the fact that the exudative retinal detachment was noted at 5 months postoperatively, after the retina had been attached at 2 months and the macular hole sealed. It seems unlikely that surgical factors could have caused this delayed event, and the anterior chamber and vitreous showed no persistent signs of infl ammation.…”

“…1 A few cases of peripheral, exudative retinal detachment and spontaneously resolving peripheral retinal detachment occurring within 2 weeks of macular hole surgery have been reported. [2][3][4][5] We present an unusual case of subfoveal, exudative retinal detachment noted at 5 months postoperatively in the presence of a sealed macular hole that had been sealed and attached at 2 months postoperatively. The detachment resolved slowly following intravitreal triamcinolone injection (IVTA).…”