{
  "abstract": "Aim To describe the clinical features, anatomical and visual outcomes of secondary full-thickness macular holes (sFTMH) developing after pars plana vitrectomy (PPV).Methods The medical charts of patients from nine vitreoretinal services across the UK who, between 2009 and 2023, underwent PPV for different indications and subsequently developed sFTMH were retrospectively reviewed. Primary outcomes were clinical features, macular hole closure rate and change in best corrected visual acuity (BCVA). Patients with idiopathic FTMH (iFTMH) who underwent surgical repair in the same period acted as control data for optical coherence tomography (OCT) characteristics.Results Out of 16 939 PPV undertaken during the study period, 60 eyes of 60 patients (52% females, mean age 61.9 years) developed sFTMH, leading to an incidence of 0.4%. Median follow-up was 24.7 months. The median time from primary PPV to sFTMH diagnosis was 3 (range 0.4–81.4) months. OCT features of sFTMH were compared with 108 cases of iFTMH. Epiretinal membrane (ERM, 24.2%), epiretinal proliferation (ERP, 9.3%) and subretinal fluid cuff (53.7%) were more commonly observed in sFTMH compared with iFTMH (11.1%, p=0.03; 1.9%, p=0.03 and 33.3%, p=0.01, respectively). 10.9% of sFTMH developing after rhegmatogenous retinal detachment (RRD) were associated with giant-retinal tear (GRT) RRD. Single surgery success rate was 93.9%. In 3 (5%) eyes, sFTMH closed spontaneously. BCVA significantly improved from 1.0 logMAR to 0.7 logMAR at final visit.Conclusions sFTMH presented more commonly with ERM and ERP compared with iFTMH. A high incidence of GRT-related RRD was observed among the RRD cohort. Surgery achieves a closure rate of 93.9% and significant vision improvement.",
  "authors": [
    {
      "affiliations": [
        "Vitreoretinal service, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, England, UK"
      ],
      "name": "Beatrice Gallo"
    },
    {
      "affiliations": [
        "Ophthalmology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, England, UK"
      ],
      "name": "Haseeb Akram"
    },
    {
      "affiliations": [
        "St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, England, UK"
      ],
      "name": "Francesco Maria D’Alterio"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Royal Berkshire NHS Foundation Trust, Reading, England, UK"
      ],
      "name": "Evgenia Anikina"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, England, UK"
      ],
      "name": "Haifa Madi"
    },
    {
      "affiliations": [
        "St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, England, UK"
      ],
      "name": "Nikolaos Dervenis"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Princess Alexandra Eye Pavillion, Edinburgh, Scotland, UK"
      ],
      "name": "Colin Goudie"
    },
    {
      "affiliations": [
        "Vitreoretinal service, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, England, UK"
      ],
      "name": "Imran Akram"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Royal Berkshire NHS Foundation Trust, Reading, England, UK"
      ],
      "name": "Mikes Nomikarios"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Royal Berkshire NHS Foundation Trust, Reading, England, UK"
      ],
      "name": "Won Young Moon"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, England, UK"
      ],
      "name": "Reshma Sonsale"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UK"
      ],
      "name": "Philip Alexander"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, England, UK"
      ],
      "name": "Pallavi Tyagi"
    },
    {
      "affiliations": [
        "St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, England, UK",
        "Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, England, UK"
      ],
      "name": "Teresa Sandinha"
    },
    {
      "affiliations": [
        "Sunderland Eye Infirmary, Sunderland, England, UK",
        "Bioscience Institute, Newcastle University, Newcastle upon Tyne, England, UK"
      ],
      "name": "David H Steel"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Kabgayi Eye Unit, Kabgayi Hospital, Muhanga, Southern Province, Rwanda",
        "College of Medicine and Health Science, University of Rwanda, Kigali, Kigali City, Rwanda"
      ],
      "name": "Michael A Mikhail"
    },
    {
      "affiliations": [
        "Vitreoretinal service, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, England, UK",
        "Vision & Eye Research Institute, Anglia Ruskin University, Chelmsford, England, UK"
      ],
      "name": "Aman Chandra"
    }
  ],
  "title": "Clinical characteristics and surgical outcomes of secondary full-thickness macular holes developing after vitrectomy",
  "uid": "48104726-9b8f-56d1-b334-e87a808903e2"
}