Natural history of foveolar lucencies observed by optical coherence tomography after macular hole surgery

Abstract

Purpose: To describe the incidence, course, and anatomic and functional outcomes of foveolar lucencies observed by optical coherence tomography after macular hole surgery.

Methods: Retrospective chart review of all idiopathic macular hole surgeries performed between February 2002 and August 2003. Available data involving eyes with foveolar lucencies after macular hole surgery were collected regarding best-corrected visual acuity, lens status, slit-lamp biomicroscopy, and optical coherence tomography before and at follow-up visits ranging from 1 week to 27 months after macular hole surgery.

Results: Thirty-five eyes of 35 patients were identified. Foveolar lucencies were detected by optical coherence tomography in 9 of the 35 eyes (26%). Operative procedures included creation of a posterior vitreous detachment in 8 eyes and indocyanine green-assisted internal limiting membrane peeling in 5 eyes. Intraocular tamponade consisted of 30% sulfur hexafluoride gas in 6 eyes and 20% perfluoropropane gas in 3 eyes with at least 1 week of face-down positioning. Postoperative visual acuity showed gradual improvement coinciding with decreasing size and eventual disappearance (3 to 11 months) of the foveolar lucency.

Conclusion: Foveolar lucencies observed by optical coherence tomography are a common finding after macular hole surgery (26%). They occur with and without indocyanine green-assisted internal limiting membrane peeling. Earlier disappearance of the foveolar lucency does not correlate with the type of gas used for tamponade. They gradually decrease and eventually resolve with time without additional surgical intervention and with further improvement of visual acuity.