Combined macular hole and cataract surgery

PURPOSE: Cataract often develops after macular hole surgery, necessitating cataract surgery. We report a combination of macular hole surgery and cataract surgery on four eyes of four patients. METHODS: Four eyes of four patients had a full-thickness stage III or IV macular hole and some degree of cataract. Combined cataract surgery with intraocular lens implant and macular hole surgery was associated with intravitreal perfluoropropane at 15% concentration and with face-down positioning for 21 days. RESULTS: After combined cataract and macular hole surgery, the rim of subretinal fluid resolved successfully in four eyes of four patients. Twelve months after surgery, the macular hole reopened in one eye in association with the new onset of macular pucker. Best-corrected visual acuities ranged from 20/25 to 20/100 12 months after surgery, while preoperative visual acuities with best correction were 20/70 to 20/200. CONCLUSIONS: In selected cases, a combination of cataract surgery with intraocular lens implant and macular hole surgery offers advantages. This combined approach warrants consideration.