Inverted flap technique with air tamponade and one day face down positioning for posttraumatic macular hole surgery in a young male patient in sub-Saharan Africa
Journal – Journal of Case Reports and Images in Ophthalmology
Publication date – Jun – 2020
Authors – Olufemi Oderinlo, Adekunle Olubola Hassan, Ogugua Okonkwo
Keywords – Full thickness macular hole, Inverted flap macular hole surgery, Macular hole, Posttraumatic macular hole
Open access – Yes
Speciality – Ophthalmology
World region Western Africa
Language – English
Submitted to the One Surgery Index on August 2, 2020 at 11:08 am
Introduction: Surgery has been the mainstay of macular hole treatment since the first description of its success. Different techniques are, however, described. Our case report looks into the use of the inverted flap technique for managing patients with posttraumatic full thickness macular holes with a single day supervised face down positioning and air tamponade.
Case Report: A 32-year-old young man sustained blunt ocular trauma to his left eye while under training seven months prior to presentation with reduced central vision and metamorphopsia. On examination visual acuities were best corrected 6/6 in the right and 6/60 in the left, anterior segments were normal. Fundoscopy revealed flat retinae, and extensive linear chorioretina scars in the posterior pole suggestive of healed choroidal ruptures and a posttraumatic stage 4 full thickness macular hole (FTMH) in the left. The FTMH measured 877 μm on optical coherence tomography (OCT). The patient had a macular hole surgery using the inverted flap technique with one-day face down positioning and air tamponade. Significant hole closure was seen in the first postoperative week and by six weeks after surgery, the macular hole was fully closed and vision improved to 6/6 best corrected. The inverted flap technique with air tamponade and one day face down positioning can offer another option to retina surgeons treating complex macular holes. Early visual recovery and ability to undertake air travel immediately after surgery is an additional advantage.
Conclusion: Using the inverted flap technique for surgery provides surgeons with another option for repair of complex FTMHs, like those secondary to trauma that have been known to respond poorly to initial standard repair.
OSI Number – 20604