Unusual closure of a large traumatic macular hole after an unorthodox pars plana vitrectomy.
H Hamdy Ghoraba, M A Abdelhafez Elsayed, A H Hamdi Ghoraba et al.
✦ AI-curated · Sources linked
Case in brief
An 11-year-old male presented with a large traumatic macular hole and a best-corrected visual acuity (BCVA) of counting fingers. Following pars plana vitrectomy (PPV) and posterior hyaloid detachment, attempts to perform a modified internal limiting membrane (ILM) flap technique were unsuccessful. However, air tamponade was applied, resulting in U-type closure of the macular hole and improvement of BCVA to 6/60.
What made this case unusual
The case is notable for the unexpected U-type closure of a large traumatic macular hole despite the inability to perform ILM surgery, which is typically recommended for such cases.
Diagnostic / clinical pearl
Clinicians should consider that macular holes may close even without ILM surgery, as demonstrated by the U-type closure observed in this case.
Why it matters
This case highlights the potential for alternative surgical outcomes in complex cases of traumatic macular holes, emphasizing the need for flexibility in surgical approaches.