Macular Buckle for Retinal Detachment with Macular Hole: Case Report


Macular Buckle for Retinal Detachment with Macular Hole Case Report by Luisa Malheiro, Bernardete Pessoa, Joao Melo Beirao, Angelina Meireles, Portugal



Macular buckling is a surgical technique used for retinal detachments due to macular hole in high myopic patients. The purpose of the macular buckle is to counteract the pulling effect of the posterior staphyloma.


To describe a case report.


We report the case of a 65 years-old high myopic female who presented to our department due to decreased visual acuity in the right eye with two months of evolution. The patient had no past history of ophthalmological surgeries. Clinical examination revealed a best corrected visual acuity (BCVA) of hand movements in the right eye and of 20/200 in the left eye. Anterior segment evaluation revealed bilateral cataracts and a normal intraocular pressure. Fundus examination showed bilateral myopic coroidosis, posterior pole staphyloma and retinal detachment associated with a macular hole in the right eye. Axial length was 30,86 mm and 30,72 mm in right and left eye, respectively. The patient underwent a combined phacovitrectomy with epiretinal peeling and inverted internal limiting membrane flap technique for macular hole associated to a small peripheral retinotomy to remove the subretinal fluid. Octafluoropropane (C3F8) gas was used as a tamponade. Postoperatively macular hole was closed but subretinal fluid was still present at the posterior staphyloma. At this time, it was performed a macular buckling surgery, using the AJL macular buckle (AJL Ophthalmic Spain). Postoperative SD-OCT showed macular superior indentation and subfoveal fluid inferioly which persisted along the follow-up. Therefore, seven months after, the macular buckle was readjusted and placed more inferioly. One month after the reintervention, SD-OCT revealed macular indentation with no subretinal fluid or retinoschisis. The BCVA of the right eye was 20/400 and remained stable until the last visit.


Combined vitrectomy with macular buckling is an effective approach in the treatment of retinal detachments due to macular hole in high myopic patients, improving both visual and anatomic outcomes.



Luisa Malheiro
Porto, Portugal
Email :
Cell Phone: +351918558414
Work Phone: +351918558414