Reopening of a Macular Hole After Nd:yag Laser Capsulotomy in a Vitrectomized Eye

In Brief Purpose: To describe a case of reopening of macular hole in a vitrectomized eye after Nd:YAG laser capsulotomy. Methods: A 70-year-old man presented with a Stage 3 macula hole 5 years previously with a vision of 6/24. Results: The patient had a vitrectomy with perfluoropropane tamponade. The macula hole closed and vision improved to 6/12. Subsequently, the patient underwent cataract surgery. The patient required Nd:YAG laser capsulotomy 18 months later for posterior capsule opacification. Assessment before laser treatment revealed the macular hole had remained closed. Immediately postlaser, the patient reported noticing a distinct central scotoma and it was later confirmed that the macular hole had reopened. He had a repeat vitrectomy with internal limiting membrane peel and perfluoropropane tamponade. The macular hole closed and vision improved to 6/18. Conclusion: To date, this represents the first case reported in the literature of reopening of a macular hole after Nd:YAG laser capsulotomy in a vitrectomized eye. This implicates causes other than changes in the vitreous for reopening of the macular hole. Macular hole has been reported as a complication of Nd:YAG laser capsulotomy. The laser energy has been implicated as the cause for changes in the vitreous which in turn leads to traction on the macular. However, the authors present a case of reopening of a macular hole in a vitrectomized eye.