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Case Reports
. 2023 Apr 17:10:1154338.
doi: 10.3389/fmed.2023.1154338. eCollection 2023.

Case report: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis post-cataract surgery

Yii Hern Eng  1 , Kah Wei Ong  1 , Meng Hsien Yong  1 , Wan Haslina Wan Abdul Halim  1 , Mae-Lynn Catherine Bastion  1
Affiliations
Case Reports

Case report: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis post-cataract surgery

Yii Hern Eng et al. Front Med (Lausanne). .

Abstract

Background: This study aimed to report a case of outer lamellar macular hole and outer retinal detachment within myopic foveoschisis (MF) post-cataract surgery.

Case presentation: An elderly female patient with bilateral high myopia and pre-existing myopic foveoschisis underwent uncomplicated sequential cataract surgeries 2 weeks apart. She was able to achieve a satisfactory visual outcome for her left eye with stable myopic foveoschisis and visual acuity of 6/7.5, near vision N6. However, her right eye vision remained poor postoperatively, with a visual acuity of 6/60. Macular optical coherence tomography (OCT) revealed a new right eye outer lamellar macular hole (OLMH) and outer retinal detachment (ORD) within pre-existing myopic foveoschisis. Her vision remained poor after 3 weeks of conservative management, and she was offered vitreoretinal surgical intervention with pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. However, she refused surgical intervention, and her right vision remained stable at 6/60 over 3 months of follow-up.

Conclusion: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis can occur soon after cataract surgery, which may be related to the progression of associated vitreomacular traction, and have a poor visual outcome if left untreated. Patients with high myopia should be informed of these complications as part of pre-operative counseling.

Keywords: cataract; myopia; myopic foveoschisis; outer lamellar macular hole; outer retinal detachment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Clinical timeline—A 77-year-old woman with reduced visual acuity and central scotoma after her right eye cataract surgery. VMT, vitreomacular traction; MF, myopic foveoschisis; VA, visual acuity; ILM, internal limiting membrane; OCT, optical coherence tomography; OLMH, outer lamellar macular hole; ORD, outer retinal detachment.
Figure 2
Figure 2
Optical coherence tomography macula of the left eye with (A) myopic foveoschisis pre-operatively and (B) stable myopic foveoschisis post-cataract surgery.
Figure 3
Figure 3
Optical coherence tomography macula of the right eye with (A) myopic foveoschisis with vitreomacular traction pre-operatively, (B) myopic foveoschisis with new-onset outer lamellar macular hole, and (C) macular detachment post-cataract surgery.
See this image and copyright information in PMC

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