Poster 3 Miriam Garcia-Fernandez

Advantages:

To report the surgical results in a case of bilateral full-thickness macular hole (FTMH) after laser-assisted in situ keratomileusis (LASIK) for myopia.

Methods:

A 53-year-old Spanish woman who had undergone LASIK for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity (VA) in both eyes. A complete ocular examination, including, among others, determination of Best Corrected Visual Acuity (BCVA), fundoscopy and Optical Coherence Tomography (OCT), was performed.

Effectiveness / Safety:

At the first visit, her BCVA was 0.4 in RE and 0.2 in LE. An anterior segment examination revealed a post-LASIK cornea with no further abnormalities in both eyes. A fundoscopy revealed an image of FTMH in both eyes. OCT (cirrus spectral domain; Carl Zeiss Meditec, Germany) examination showed a stage IV macular hole in RE and LE, with subretinal fluid surrounding the defect, and an absence of yellow deposits on the retinal pigment epithelium. We also observed a posterior vitreous detachment in both eyes. 23-gauge sutureless pars plana vitrectomy and sulphur hexafluoride gas as tamponade was performed at 30 days after diagnosis with a time interval of 1 month between both eyes. A prone position was advised for 1 week. One month after vitrectomy, the patient’s BCVA was 1.0 in RE and 0.6 in LE. A retinal examination revealed the closure of the macular hole in both eyes and OCT confirmed the restoration of the macular defect. At this time no complications were observed, however, we could appreciate a slight decrease in the foveal central thickness (125µ of residual foveal thickness) of the patient’s LE. We also observed a moderate alteration of the junctional layer of the inner and outer segments of photoreceptors in both eyes. Six months after surgery the visual acuity and the anatomic appearance remained unchanged. The effectiveness and safety of surgery in this case did not differ from other cases of full thickness macular hole. Therefore, conventional macular hole surgery in these cases is an effective and safe technique.