Journal
BRITISH JOURNAL OF OPHTHALMOLOGY
Volume 90, Issue 3, Pages 293-295Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bjo.2005.078188
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Aim: To report on a new postoperative finding after delamination of the internal limiting membrane (ILM) for the treatment of different macular pathologies. Methods: Seven patients are described with paracentral retinal holes, all located temporally to the macula, which developed after pars plana vitrectomy and uncomplicated ILM removal for cystoid macular oedema (n = 3), macular pucker (n = 3), and macular hole (n = 1) with the use of indocyanine green (n = 4), trypan blue (n = 1), triamcinolone acetonide (n = 1), or without dye (n = 1). Conclusion: The use of dyes has been incriminated in causing iatrogenic damage to the retina. In this series, the new observation of retinal holes in the macular area is thought to be related to the removal of the ILM itself. The authors speculate that ILM delamination may cause a retinal weakening by Muller cell damage; this may be followed by a structural breakdown and, consequently, hole formation.
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