This patient’s symptomatic 20/80 vitreomacular traction was treated with pneumatic vitreolysis, where a small gas bubble was injected into the vitreous cavity to induce a posterior vitreous detachment. The patient wished to try this less invasive option instead of vitrectomy.
Although the traction successfully released 1 week postop, the patient developed an immediate macular hole with 20/100 vision.
Since the hole was tiny with some cystoid edema (CME), a trial of topical prednisolone acetate 1% and ketorolac was given.
One month later, the CME resolved and the hole closed with improvement to 20/60.
Learning Points:
Topical prednisolone acetate 1% and ketorolac is a newly described treatment that can occasionally be tried for macular holes without traction.
