Artikel
The “dance” over the macula after ocular contusion
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Veröffentlicht: | 23. November 2017 |
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Gliederung
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Purpose: A macular hole is a rare complication after contusion or rupture of the eyeball. The management is discussed controversially because of the chance of spontaneous hole closure.
Effectiveness: A 26-year-old male was injured by a hit with orbital and nasal fracture. Visual acuity (VA) was hand motion (HM) OD. A central choroidal rupture with subretinal bleeding and a macular hole IV was observed. Because of a large (diameter 3 mm) central retinal detachment a pars plana vitrectomy with ILM-peeling was performed and a 180° ora serrata dialysis was treated with laser retinopexy.
Our way – Tips and Tricks: The drainage of the subretinal bleeding was performed through a “dance” over the macula with a perfluorodecalin bubble.
Conclusions: ILM-peeling and subretinal drainage did lead to a significant improvement of visual acuity up to 20/200. The macular hole was closed without any subretinal bleeding.
Take home message: The vitrectomy with lavage of subretinal fluid and ILM-peeling may lead to restoration of visual acuity especially in cases of severe ocular trauma with choroidal rupture and macular hole.