Reopening of macular holes after initially successful repair

Objective: To evaluate the frequency and prognosis of reopening of a macular hole after initially successful repair in a defined patient cohort. Design: Retrospective consecutive noncomparative case series. Participants: Seventeen cases of reopened macular holes among 390 cases of idiopathic: macular holes that previously had undergone macular hole surgery were studied. Main Outcome Measures: Assessment of demographics, visual acuity, preoperatively, postoperatively, after reopening of macular hole and after reoperation, if applicable, and precipitating factors. Results: There were 17 (4.8%) of 353 cases in which the macular hole reopened after initial successful surgical closure. The mean visual acuity before reopening was 10/48 and was 20/133 after reopening. Twelve eyes underwent reoperation with improvement to a mean visual acuity of 20/54, The five eyes that were not reoperated on maintained a mean visual acuity of 20/200, Ten of the eyes had undergone cataract surgery between macular hole surgeries, but in only one did the reopening appear to occur in association with this procedure. Conclusions: Reopening of a previously successfully operated macular hole is uncommon and seems to be a spontaneous event. Reoperation generally yields results similar to those present before the reopening. Reopening of a macular hole associated with cataract surgery is rare.