ABSTRACT
PURPOSE: To describe a unique complication of macular hole repair surgery using a subretinal human amniotic membrane plug. METHODS: Retrospective, interventional case report. RESULTS: A 71-year-old man presented with a chronic full-thickness macular hole in his left eye. Conventional 23-gauge pars plana vitrectomy with internal limiting membrane peeling and implantation of a subretinal human amniotic membrane plug was performed. In the postoperative period, centripetal growth of external retinal layers was observed under the plug. Six months after the surgery, the human amniotic membrane plug was completely integrated into the retina. CONCLUSION: This is the first reported case of intraretinal integration of a human amniotic membrane plug after macular hole repair surgery.
Subject(s)
Retinal Perforations , Male , Humans , Aged , Retinal Perforations/surgery , Retinal Perforations/etiology , Retrospective Studies , Amnion , Visual Acuity , Tomography, Optical Coherence , Vitrectomy/adverse effectsABSTRACT
Bilateral macular hole is a rare secondary effect of tamoxifen, a condition which is probably underdiagnosed. We describe the case of a 63-year-old woman who had received low-dose treatment with tamoxifen for 10 years. She presented with a best-corrected visual acuity of 20/40 in both eyes and bilateral macular hole with posterior hyaloid attachment. No reflective deposits were observed. A 23-gauge pars plana vitrectomy with internal limiting membrane peeling and gas tamponade was performed in the right eye with no anatomical or functional improvement. The most accepted mechanism of macular hole related to tamoxifen is Müller cell toxicity with retinal tissue loss. Therefore, it seems that the standard procedure used in idiopathic macular hole is not the optimal choice, due to a different pathogenic mechanism.