Management of fovea-involving dry macular fold complicating retinal detachment surgery: Does delayed intervention influence outcome?

Abstract

Retinal folds are rare complications of rhegmatogenous retinal detachment surgery. They may be located in periphery or involve macula, with the latter ones being associated with severe visual loss. Due to the paucity of scientific reports, its management remains debatable. Most authors advocate an early surgical intervention for symptomatic macular folds (MF). We present 2 cases of symptomatic dry macular fold which were managed successfully after different time intervals. As evidence gets collected that late intervention also leads to good visual outcome, long standing MF should not be considered an absolute contraindication for surgical intervention.

Keywords: Early; Perfluorocarbon liquid; late; macular fold; retinal detachment.

Figure 1

Intra-operative images of the surgical technique followed showing (a) balanced saline solution being injected into the subretinal space, outside the arcades with the help of a 41G cannula to intentionally induce retinal detachment till all the blebs coalesce together, (b) perfluorocarbon liquid being injected over the posterior pole, and (c) diamond dusted membrane scraper being used to gently stroke and unfold the macular fold

Figure 2

Fundus images of Case number 1 showing (a) pre-operative status with macular fold (MF) passing through the macula, (b) post-operative status with silicon oil in-situ with resolved MF, and (c) status post-silicon oil removal

Figure 3

Images of line scan of optical coherence tomography of case number 2 showing (a) pre-operative horizontal scan through the macular fold (MF), (b) pre-operative vertical scan through the MF, and (c) post-operative horizontal scan with silicon oil in-situ showing the resolution of MF