MACULAR HOLE FORMATION AND CLOSURE AFTER CATARACT EXTRACTION AND Nd:YAG CAPSULOTOMY IN A VITRECTOMIZED EYE WITH AN EPIRETINAL MEMBRANE.

Background: Vitreomacular traction and degeneration of the inner retinal layers of the fovea are considered contributing factors to idiopathic macular hole (MH) formation. This case report illustrates a rare scenario of MH formation and spontaneous closure associated with an epiretinal membrane (ERM) and perifoveal cystoid edema without anteroposterior traction from the vitreous in a previously vitrectomized eye.

Methods: A case report following MH clinical progression with visual acuity and serial optical coherence tomography.

Results: A 47-year-old high myope underwent scleral buckle placement and pars plana vitrectomy for a macula-off, phakic, inferior retinal detachment with a giant retinal tear and proliferative vitreoretinopathy 2.5 years ago with eventual visual acuity of 20/20. Postoperatively, an ERM developed, and uncomplicated phacoemulsification cataract extraction was later performed. One week after Nd:YAG capsulotomy, a full-thickness MH formed (with perifoveal cystoid macular edema) that spontaneously resolved 2 months later with return of vision to 20/20.

Conclusion: After vitrectomy, anteroposterior vitreofoveal traction no longer contributes to MH formation. Perifoveal cystoid macular edema as well as tangential traction from ERMs may contribute to MH formation.