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  • Surgical management of full-thickness macular hole following Nd:YAG laser hyaloidotomy for pre-macular haemorrhage in a patient with anaemic retinopathy

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Case Reports: Rare disease
Surgical management of full-thickness macular hole following Nd:YAG laser hyaloidotomy for pre-macular haemorrhage in a patient with anaemic retinopathy
  1. Naresh Babu Kannan1,
  2. Piyush Kohli1,2,
  3. Chitaranjan Mishra1 and
  4. Obulu Ramachandran N1
  1. 1Department of Retina Vitreous, Aravind Eye Hospital, Madurai, Tamil Nadu, India
  2. 2C.L. Gupta Eye Institute, Moradabad, Uttar Pradesh, India
  1. Correspondence to Dr Piyush Kohli; kohli119{at}gmail.com

Abstract

Pre-macular haemorrhage (PMH) can cause profound visual loss. Some surgeons prefer neodymium-doped yttrium aluminium garnet (Nd:YAG) hyaloidotomy as the first line of treatment due to being an easy technique and having a high success rate. However, the use of high energy close to the fovea can lead to various macular complications. We present a case of a patient who presented with PMH secondary to anaemic retinopathy. He underwent Nd:YAG laser hyaloidotomy, but developed a full-thickness macular hole. He further underwent vitrectomy and a type 1 closure was achieved. However, the visual gain was poor due to the large hole size and the collateral thermal damage. The hole may not close spontaneously, thus requiring surgical intervention. The surgical outcome of these holes depends on the size of the hole and the collateral thermal damage caused during the laser procedure.

  • Macula
  • Retina

https://doi.org/10.1136/bcr-2022-249564

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    Footnotes

    • Contributors NBK contributed to acquisition of data or analysis and interpretation of data and the drafting of the article or revising it critically for important intellectual content. PK and CM contributed to the conception and design, acquisition of data or analysis and interpretation of data and the drafting of the article or revising it critically for important intellectual content. ORN contributed to acquisition of data or analysis and interpretation of data and the drafting of the article or revising it critically for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.