POSTERIOR SEGMENT COMPLICATIONS AFTER VITRECTOMY FOR MACULAR HOLE

Purpose: The purpose of this study is to assess the rate of posterior segment complications after vitreous surgery for macular holes and to evaluate the effect of such complications on final visual outcome. Met hods: The authors reviewed retrospectively all cases of vitreous surge ry for macular holes performed between June 1990 and October 1993. Amo ng 98 patients with a followup of 3 months or more, all patients with posterior segment complications during the postoperative course were i dentified. The rate of complications was compared with that seen after vitreous surgery for macular pucker performed by the same surgeons. R esults: Posterior segment complications were noted in 23 (23%) of 98 p atients. These included peripheral retinal breaks (3%), rhegmatogenous retinal detachment from a peripheral retinal break (14%), enlargement of the hole (2%), late reopening of the hole (2%), retinal pigment ep ithelium loss under the hole (1%), photic toxicity (1%), and endophtha lmitis (1%). In 40% of these eyes, the final visual acuity was two lin es or more below preoperative visual acuity. When compared with the ma cular pucker group, the rate of posterior segment complications, in pa rticular the rate of peripheral retinal tears and detachments, was sig nificantly higher (P less than or equal to 0.05). Conclusions: The aut hors conclude that visually significant posterior segment complication s may occur after vitrectomy for macular hole, and the rate of these c omplications appears to be higher than expected.