Progressive retinoschisis and retinal detachment after uncomplicated macular hole repair surgery

Abstract

Purpose

To report a rare case of progressive retinoschisis and retinal detachment after uncomplicated macular hole (MH) surgery.

Case description

A 67-year-old man with recent onset vision complaints in the right eye (visual acuity – 20/30), was diagnosed with a small idiopathic full-thickness MH. He underwent a 3-port 25G pars plana vitrectomy surgery with internal limiting membrane peeling and air endotamponade.

Results

MH closed with a normal foveal contour and intact retinal layers by the 1^st post operative week and vision improved to 20/20. At the 7^th week follow-up period, the patient complained of visual disturbances in his right eye for 2 days. Optical coherence tomography scans revealed development of peripheral retinoschisis which progressed towards the macula over the next 4 weeks. At the 13^th week following the retinal surgery, patient developed sudden profound vision loss to hand motions and a total retinal detachment was noted. He underwent a second retinal surgery with retinectomy to the stiff retina and silicone oil endotamponade. At the last follow-up visit 8 weeks after the second surgery, the visual acuity had improved to 20/120 and the retina was well-attached with silicone oil in place.

Conclusion

We present a rare case of progressive retinoschisis and retinal detachment caused by residual ILM contraction after MH repair surgery. To the best of our knowledge, no such complication after MH repair surgery has been reported in the literature.