Macular hole surgery in an eye with an optic pit

PURPOSE: To report an eye with a full-thickness macular hole and an associa ted optic pit and the noteworthy intraoperative findings. METHODS: Case report. A 56-year-old woman presented with visual acuity LE: 20/100, a full thickness macular hole, and an optic pit. Optical coherence tomography and ophthalmic examination were performed preoperatively and pos toperatively. RESULTS: Although usually a macular hole associated with an optic pit tends to be a lamellar and characterized by outer layer defects within preexisti ng macular detachments or schisis-like cavities, this type of macular hole was not presented in this case. Although the macular hole resembled the idi opathic type on clinical examination as well as on optical coherence tomogr aphy, it could only be closed in the third surgical attempt after using sil icone oil as a long-standing tamponade. Peeling of an epiretinal membrane o r the internal limiting membrane was not possible during any of the three s urgeries. CONCLUSION: Our observations suggest that in cases of macular hole in assoc iation with optic pit, instillation of silicone oil should be considered in the first surgical procedure, especially if no epiretinal membrane or inte rnal limiting membrane peeling is possible intraoperatively. (C) 2001 by El sevier Science Inc. All rights reserved.