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Conversion from type 2 to type 1 macular hole closure after surgery in high myopia.

Ramesh VenkateshArpitha PereiraNikitha Gurram ReddyNaresh Kumar Yadav
Published in: BMJ case reports (2021)
We describe a case of spontaneous conversion from type 2 macular hole (MH) closure to type 1 closure following MH surgery in high myopia. A 42-year-old male patient with myopia was diagnosed with full-thickness MH and localised neurosensory detachment. His best-corrected vision in the right eye was 20/120, N18. He underwent pars plana vitrectomy with internal limiting membrane peeling and silicone oil tamponade. Nine days after surgery, optical coherence tomography (OCT) showed type 2 MH closure and presence of epiretinal tissue. At 6 weeks of follow-up, there was spontaneous conversion from type 2 to type 1 closure of MH with a thin epimacular tissue bridging across the fovea and vision improving to 20/80. At 3 months after surgery, silicon oil removal was done. OCT showed a closed type 1 MH and visual acuity of 20/80 at the final visit. Early spontaneous conversion in closure can occur over time, leading to better anatomical and visual outcomes.
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