Macular Holes and Excellent Visual Acuity

Abstract

To the Editor. —Lewis et al¹ recently reported the apparent disappearance of a macular hole in association with changes in an epiretinal membrane. We have observed a marked decrease in the visibility and apparent size of macular holes in two patients, with remarkable restoration of excellent visual acuity (20/20). Report of Cases. —Case 1. —A 35-year-old black man with hemoglobin SC disease demonstrated progressive vitreous traction bands, peripheral neovascularization, and macular epiretinal membranes in his left eye. This case has been described previously.² Attempts at lysis of vitreous traction with the neodymium-YAG laser were only partly successful. The patient's visual acuity deteriorated from 20/60 to 20/200 OS, and in May 1985 he developed a combined tractional-rhegmatogenous macular detachment with a full-thickness macular hole (Fig 1). He underwent a vitrectomy and membrane-peeling procedure with cryopexy to a temporal neovascular frond. Subretinal fluid was drained internally through the macular