AUTHOR=Eng Yii Hern , Ong Kah Wei , Yong Meng Hsien , Wan Abdul Halim Wan Haslina , Bastion Mae-Lynn Catherine 

TITLE=Case report: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis post-cataract surgery

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1154338

DOI=10.3389/fmed.2023.1154338

ISSN=2296-858X

ABSTRACT=Background: To report a case of outer lamellar macular hole and outer retinal detachment within myopic foveoschisis (MF) post-cataract surgery.

Case presentation: An elderly female with bilateral high myopia and pre-existing myopic foveoschisis underwent uncomplicated sequential cataract surgeries two weeks apart. She was able to achieve a satisfactory visual outcome for her left eye with stable myopic foveoschisis and visual acuity of 6/7.5, near vision N6. However, her right eye vision remained poor post-operatively, with visual acuity of 6/60. Macular optical coherence tomography (OCT) revealed a new right eye outer lamellar macular hole (OLMH) and outer retinal detachment (ORD) within pre-existing myopic foveoschisis. Her vision remained poor after three weeks of conservative management, and she was offered vitreoretinal surgical intervention with pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. However, she refused surgical intervention and her right vision remained stable at 6/60 over three months of follow-up.  

Conclusion: Outer lamellar macular hole and outer retinal detachment within myopic foveoschisis can occur soon after cataract surgery, which may be related to the progression of associated vitreomacular traction. It has a poor visual outcome if left untreated. Patients with high myopia should be informed of these complications as part of pre-operative counselling.