J Korean Ophthalmol Soc > Volume 57(5); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(5):853-856.
DOI: https://doi.org/10.3341/jkos.2016.57.5.853    Published online May 15, 2016.
A Case of Failed Macular Hole Closure Associated with an Entrapped Microbubble in the Hole.
Jinhyun Kim, Gwon Hwi Lee, Seung Woo Lee
Department of Ophthalmology, Dongguk University College of Medicine, Gyeongju, Korea. jazzhanul@hanmail.net
황반원공 내에 감돈된 작은 가스방울로 인한 황반원공폐쇄 실패 1예
김진현⋅이권휘⋅이승우
동국대학교 의과대학 안과학교실
Received: 18 February 2016   • Revised: 25 March 2016   • Accepted: 22 April 2016
Abstract
PURPOSE
To report a case of failed sealing of full-thickness macular hole associated with an entrapped microbubble in the hole after vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection. CASE SUMMARY: A 69-year-old female visited our clinic for decreased visual acuity in her right eye. The best corrected visual acuity (BCVA) was 20/200 in the right eye. The fundoscopy and spectral domain optical coherence tomography (SD-OCT) showed a full-thickness macular hole. She had a history of spine surgery and, thus was unable to maintain a prone position after surgery. The patient underwent pars plana vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection in a sitting position postoperatively. Three weeks postoperatively, fundoscopy showed an entrapped microbubble within the macular hole, which was not sealed as observed on SD-OCT. We thought the entrapped microbubble within the macular hole prevented closure of the hole and removed it during the repeated surgery. At 2 weeks after the microbubble removal, fundoscopy and SD-OCT in the right eye showed the closure of the macular hole and the BCVA was improved to 20/40. CONCLUSIONS: We experienced a failed sealing of full-thickness macular hole due to an entrapped microbubble within the hole after macular hole surgery and observed the closure of the macular hole after removal of the microbubble. Based on our results, early microbubble removal operation should be considered in the treatment of an entrapped microbubble within the hole.
Key Words: Macular hole;Microbubble;Vitrectomy


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