case_images: PMC10866610_01
case_images: Funduscopic examination and optical coherence tomography (OCT) findings at the initial visit and before/after LMH and FTMH surgery, and the area of ILM peeling during initial and reoperation. a, b Fundoscopic examination and OCT at the initial visit revealed the presence of a lamellar macular hole (LMH) and a thin epiretinal membrane. One month after the initial operation, a follow-up fundoscopic examination and OCT showed that the LMH had closed (e) and the epiretinal membrane was successfully removed (d). Three months after the initial procedure, the full-thickness macular hole (FTMH) was not clearly visible in the fundus (g) but was observed on the OCT scan (h). Area of ILM peeling at initial operation (c) and reoperation (f). Tractions from the nasal side of the FTMH were seen (h), and additional ILM peeling was performed on the nasal side (f). OCT showed that the FTMH had closed (i, j) 3 weeks after reoperation.
case_images: cop-2024-0015-0001-536338_F01.jpg
case_images: PMC10866610_01_cop-2024-0015-0001-536338_F01.jpg
case_images: F1
case_images: A 54-year-old woman presented with distorted vision in her left eye and was diagnosed with a lamellar macular hole (LMH) (Fig. 1a, b). Surgical interventions included cataract surgery, 25-gauge pars plana vitrectomy with ILM peeling (Fig. 1c), lamellar hole epiretinal proliferation embedding technique, and air tamponade, with the patient maintaining a prone position for 3 days (Intervention 1). The LMH closed within a month, and visual acuity improved to 20/40 (Fig. 1d, e). However, FTMH developed in her left eye 3 months after surgery, with visual acuity declining to 20/100 (Fig. 1g, h). Subsequent vitrectomy involving extensive ILM peeling (Fig. 1f) and 20% sulfur hexafluoride (SF6) tamponade, with the patient maintaining a prone position for at least 3 days (intervention 2), achieved closure of the FTMH within 19 days, resulting in a visual acuity of 20/66 (Fig. 1i, j).
case_images: Funduscopic examination and OCT findings before/after gas tamponade alone. One and a half months after reoperation, the pinhole FTMH is not clearly visible in the fundus (a), but is observed on OCT (b). 3.5 months after reoperation, the FTMH was visible in the fundus (c), and FTMH enlargement resembling retinal detachment was observed on OCT (d). More than 1 year after gas injection, the full-thickness macular hole (FTMH) had been closed (e, f).
case_images: cop-2024-0015-0001-536338_F02.jpg
case_images: PMC10866610_01_cop-2024-0015-0001-536338_F02.jpg
case_images: F2
case_images: A pinhole-shaped FTMH appeared 1.5 months later (Fig. 2a, b), prompting follow-up owing to the patient's refusal to undergo additional surgery. FTMH enlargement resembling retinal detachment (Fig. 2c, d) with visual acuity declining to 20/125, outpatient FGX with 14% perfluoropropane (C3F8) was performed 3.5 months after reoperation, and the patient maintained a prone position for at least 3 days (Intervention 3). FTMH closure was achieved within a week post-gas injection, which was maintained for over a year with visual acuity reaching 20/50 (Fig. 2e, f).