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Secondary paracentral retinal holes following internal limiting membrane removal
  1. P Steven1,
  2. H Laqua1,
  3. D Wong2,
  4. H Hoerauf1
  1. 1University Eye Hospital of Schleswig-Holstein, Campus Luebeck, Germany
  2. 2St Paul’s Eye Unit, Royal Liverpool University, UK
  1. Correspondence to: Philipp Steven MD, University Eye Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany; psteven{at}gmx.de

Abstract

Aim: To report on a new postoperative finding after delamination of the internal limiting membrane (ILM) for the treatment of different macular pathologies.

Methods: Seven patients are described with paracentral retinal holes, all located temporally to the macula, which developed after pars plana vitrectomy and uncomplicated ILM removal for cystoid macular oedema (n = 3), macular pucker (n = 3), and macular hole (n = 1) with the use of indocyanine green (n = 4), trypan blue (n = 1), triamcinolone acetonide (n = 1), or without dye (n = 1).

Conclusion: The use of dyes has been incriminated in causing iatrogenic damage to the retina. In this series, the new observation of retinal holes in the macular area is thought to be related to the removal of the ILM itself. The authors speculate that ILM delamination may cause a retinal weakening by Müller cell damage; this may be followed by a structural breakdown and, consequently, hole formation.

  • ICG, indocyanine green
  • ILM, internal limiting membrane
  • TA, triamcinolone acetonide
  • TB, trypan blue
  • internal limiting membrane
  • retinal holes
  • trypan blue
  • ICG, indocyanine green
  • ILM, internal limiting membrane
  • TA, triamcinolone acetonide
  • TB, trypan blue
  • internal limiting membrane
  • retinal holes
  • trypan blue

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