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October 1988

Macular Holes and Excellent Visual Acuity

Arch Ophthalmol. 1988;106(10):1350-1351. doi:10.1001/archopht.1988.01060140514011

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