Visual Field Loss After Vitreous Surgery

We, too, have observed visual field loss after vitreous surgery for macular holes similar to that described by Kerrison et al1in the May 1996 issue of theArchivesand by others.2,3Disc pallor or nerve fiber layer loss did not develop in the 2 patients we studied, and perimetry and electrophysiologic test results were more consistent with retinal than optic nerve injury. A stage 3 macular hole developed in the left eye of a 71-year-old woman (case 1) who had a visual acuity of 20/200 OS. Pars plana vitrectomy with membrane peeling and fluid-gas exchange was performed with successful closure of the hole. Her visual acuity recovered to 20/40 OS. The maximal intraocular pressure was 25 mm Hg OS 6 hours after surgery. Immediately postoperatively, she noted temporal field loss (Figure, top). No abnormality of the optic disc or retina was identified during ophthalmoscopy or fluorescein angiography.