To report the characteristics and surgical outcomes of macular holes (MHs) that develop after rhegmatogenous retinal detachment (RD) repair.


A retrospective chart review was performed in patients who developed a full-thickness macular hole after RD repair between May 2010 to July 2013. The eyes underwent MH repair with pars plana vitrectomy, internal limiting membrane peeling and gas tamponade. Main outcomes included macular attachment status and postoperative visual acuity.


Fourteen eyes with full-thickness macular holes were detected in a series of 2,815 eyes (0.49% prevalence) that had undergone successful RD repair. Ten MHs developed after primary vitrectomy, and 4 MHs after scleral bucking surgery. The fovea had been detached in 8 of the 14 eyes at the time of RD. The mean time from primary RD surgery to the diagnosis of a MH was 7 months (range : 0.5-95). All 14 eyes were managed by (repeat) pars plana vitrectomy, peeling of internal limiting membrane and intravitreal gas tamponade. 12 out of 14 eyes achieved MH closure. Mean preoperative Snellen best-corrected visual acuity (BCVA) was 20/63 (± 0.25). Nine of 14 eyes had an BCVA improvement of at least 2 Snellen lines and 5 remained unchanged.


In this small retrospective study, secondary MHs were seen predominantly after macula-off RD and appeared more frequent after primary vitrectomy than after scleral buckling. Conventional MH surgery was able to close 85,7% of secondary macular holes, which almost as effective as surgery for idiopathic MHs. The surgical outcome and postoperative visual acuity gain were favourable, although final BCVA was dependent on the macular status during previous RD.