Spontaneous late reopening of a successfully operated and closed full-thickness macular hole

Abstract

Purpose: To report a case of myopic young male with spontaneous late reopening of a closed full thickness macular hole without any of the known contributing factors. Observations: A 37-year-old male who presented with gradual, progressive and painless diminution of vision in right eye was diagnosed with climatic droplet keratopathy and total retinal detachment with full thickness macular hole. Penetrating keratoplasty with temporary keratoprosthesis combined with total pars plana vitrectomy, internal limiting membrane peeling, fluid air exchange, 360° endolaser and silicone oil injection was done. Postoperatively, retina was well-attached and macular OCT showed a type 2 V-shaped closure. Later, it went on to a type 4 open closure and reopening of the hole after 1 year. Conclusions and importance: Reopening of a successfully repaired (with internal limiting membrane peeling) and closed full thickness macular hole without any evidence of known contributing factors (epiretinal membrane, cataract surgery, trauma and cystoid macular edema) is very rare. Further studies are necessary to elucidate the factors that may be involved in the recurrence of full thickness macular hole.

Keywords

• Macular hole reopening
• Internal limiting membrane peeling
• Recurrence of macular hole