Recurrent macular hole retinal detachment in a patient with pathologic myopia treated by additional intravitreal silicone oil injection: A case report

Abstract

Rationale: Treatment of macular hole retinal detachment (MHRD) in patients with pathologic myopia may require multiple surgeries due to the risk of surgical failures or recurrences. Intravitreal silicone oil injection before an additional surgery may be another option for recurrent MHRD in aphakic eyes, but this procedure is rarely performed.

Patient concerns: A 69-year-old man visited the hospital with a chief complaint of metamorphopsia in his right eye for 5 days. The right eye had undergone a cataract extraction 5 years prior and an Nd:YAG laser capsulotomy 1 year prior. The axial length was 36.18 mm; the fundus examination and optical coherence tomography (OCT) revealed inferior retinal detachment with a macular hole involving the posterior pole. Pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, endolaser photocoagulation, and silicone oil tamponade were performed. Five months after the surgery, the retina was detached, and a macular hole was observed.

Diagnosis: Recurrent MHRD in a patient with pathologic myopia.

Intervention: PPV with ILM peeling, endolaser photocoagulation, and silicone oil tamponade at the initial visit and additional intravitreal silicone oil injection (0.5 ml) at follow-up visits.

Outcomes: The retina was well-attached until 5 months after the additional intravitreal silicone oil injection.

Lessons: Additional intravitreal silicone oil injection can be a good option for treating MHRD in aphakic eyes if the detachment of the retina is dependent on posturing. The surgeon should consider the volume of silicone oil or postoperative posturing in the treatment of MHRD.