Traumatisches Makulaforamen

Abstract

The traumatic macular hole (TMH) is a rare complication of a blunt or an open injury of the globe and can lead to permanent loss of vision. The pathomechanism of TMH differs from that of the idiopathic macular hole (IMH). A sudden compression and expansion of the globe leads to vitreous traction, which can result in a TMH. The final visual acuity depends on the severity of the disruption of the photoreceptors and the retinal pigment epithelial cells. The posttraumatic approach is discussed controversially. A spontaneous closure and, therefore, a conservative approach should be considered in young patients with minor defects and good visual acuity without detachment of the posterior vitreous body. In these cases, it is advisable to wait for months. In the absence of adhesion at the edges of the hole and concomitant pathologies of the pigment epithelium, the spontaneous closure is improbable. In this case, a pars plana vitrectomy with removal of the vitreous and epiretinal membranes can lead to anatomical reconstruction and improvement of the visual acuity. The success of an operative intervention is complex and is associated with the experience of the surgeon as well as the characteristics of the trauma.

Comparative Study between Pars Plana Vitrectomy with Internal Limiting Membrane Peel and Pars Plana Vitrectomy with Internal Limiting Membrane Flap Technique for Management of Traumatic Full Thickness Macular Holes

“…This meant posing a significant pathological element that could not be rectified by the aforementioned surgical maneuvers and that hindered anatomical closure and retinal layers' structural recovery. Accordingly, traumatic FTMH acquired notoriety of frequent initial failure, late reopening, and worse final visual outcome compared to the primary variant [18, 19]. The aim of the current study is to compare the efficacy of PPV and ILM peel versus PPV and ILM flap technique (IFT) in terms of anatomic and functional outcomes in patients with traumatic FTMH.…”