Full-thickness macular hole secondary to high-power handheld blue laser: Natural history and management outcomes

Sulaiman M. Alsulaiman, Abdulaziz Adel Alrushood, Jluwi Almasaud, Abdullah S. Alkharashi, Yahya Alzahrani, Emad B. Abboud, Sawsan R. Nowilaty, J. Fernando Arevalo, Mohammad Al-Amry, Saba Alrashaed, Nicola G. Ghazi, Eman Al Kahtani, Saba Al Rashaed, Hassan A. Al-Dhibi, Yahya A. Al-Zahrani, Igor Kozak, Sulaiman Al-Sulaiman, Abdulelah Al-Abdullah, Ahmad Al-Bar, Yousef Al DhafiriAbdullah Al Qahtani, Khalid Al Rubaie, Saeed Al Shahrani, Maha Al Shehri, Badr Al Ahmadi, Abdulaziz Al Hadlaq, Majed Al Harbi, Abdulaziz Al Oreany

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Abstract

Purpose To report the natural history and management outcomes of full-thickness macular hole (MH) caused by momentary exposure to a high-power handheld blue laser device and highlight the dangers of such easily available devices. Design Retrospective consecutive case series. Methods A chart review of all patients presenting with full-thickness MH from exposure to blue-light high-powered lasers from January 2012 to May 2014 at 2 institutions was performed. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography. The main and secondary outcomes were MH closure and final visual acuity, respectively. Results There were 17 eyes of 17 patients with full-thickness MH. Best-corrected Snellen visual acuity (BCVA) at presentation ranged from 20/30 to 2/200 (mean: 20/210). The MH minimum diameter ranged from 168 μm to 620 μm (mean: 351 μm). Fourteen eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas or silicone oil tamponade. Eleven of the 14 (78.6%) operated eyes had complete closure of the macular hole. Of the 3 unoperated eyes, only 1 eye with the smallest macular hole (minimum diameter: 168 μm) closed spontaneously with observation. Final BCVA in all cases had a mean of 20/62 (range: 20/20-4/200). Conclusion Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.

Original languageEnglish (US)
Pages (from-to)107-113.e1
JournalAmerican journal of ophthalmology
Volume160
Issue number1
DOIs
StatePublished - Jul 1 2015

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ASJC Scopus subject areas

  • Ophthalmology

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Alsulaiman, S. M., Alrushood, A. A., Almasaud, J., Alkharashi, A. S., Alzahrani, Y., Abboud, E. B., Nowilaty, S. R., Arevalo, J. F., Al-Amry, M., Alrashaed, S., Ghazi, N. G., Al Kahtani, E., Al Rashaed, S., Al-Dhibi, H. A., Al-Zahrani, Y. A., Kozak, I., Al-Sulaiman, S., Al-Abdullah, A., Al-Bar, A., ... Al Oreany, A. (2015). Full-thickness macular hole secondary to high-power handheld blue laser: Natural history and management outcomes. American journal of ophthalmology, 160(1), 107-113.e1. https://doi.org/10.1016/j.ajo.2015.04.014