Post Vitrectomy Macular Folds. The Final Outcome



To present the characteristics of 3 eyes complicated by macular folds following parsplana vitrectomy for retinal detachment.


All three patients presented with upper bullous retinal detachments to which pars plana vitrectomy with gas injection was performed. Perfluorocarbon heavy liquid (PFCL) was used to flatten the retina and PFCL/air exchange was performed at the end of the surgery. The macular folds were identified within the first week following partial gas absorption. OCT confirmed the diagnosis. The visual performance was severely compromised in all 3 eyes. This ranges from 2/60 to 0.1. One eye developed a macular hole together with fold. Surgery to flatten the fold was performed in two eye.


Redetatching the central retina using 41 cannula and unfolding the retinal using diamond dusted silicone scraper followed by air injection was then performed. The manoeuvre was successful in unfolding the retinal fold in both cases. However, The visual recovery was limited and the best corrected vision ranged from 0.15 to 0.25. Both patients reported improvement in the metamprphopsia.


Reparations on postoperative macular folds may improve the anatomical configuration of the macular but the visual recovery is limited. Prevention is the way to go.



Mahmoud Soliman
Cairo, Egypt
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