Sustained closure of surgically repaired macular holes after retinal detachment with submacular fluid

PURPOSE: To examine the behavior of surgically repaired macular holes when subsequent retinal detachment with submacular fluid develops and to correlate these observations with current theories of macular hole formation and closure. METHODS: We reviewed the medical records of four patients who underwent successful surgical closure of macular holes and subsequently developed rhegmatogenous retinal detachment with macular involvement. RESULTS: No reopening of the original macular hole occurred in any of the four patients. No focal macular attachment was seen that would suggest firm adherence of the macular hole edges to the underlying retinal pigment epithelium. CONCLUSIONS: When retinal detachment with submacular fluid develops in patients with a successfully closed macular hole, sustained closure of the macular dehiscence is typically seen. These findings support reapproximation of the hole edges with an associated retinal wound healing response as the mechanism of hole closure.