PubMed · 13851179
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D M GORDON. 1960. Common ocular problems.. https://pubmed.ncbi.nlm.nih.gov/13851179/
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PURPOSE: To report an unusual preretinal opacity associated with an idiopathic macular hole (MH) that was identified by optical coherence tomography. DESIGN: Observational case report. METHODS: A 59-year-old woman with a preretinal linear opacity running across an MH was examined by optical coherence tomography. RESULTS: Optical coherence tomography showed a full-thickness MH with a superiorly hinged flap. The preretinal opacity was identified as a part of a laminated vitreous cortex that was perpendicularly attached to the apex of the flap. A horizontal scan showed a partly double-layered posterior vitreous cortex. Two months later, the linear opacity disappeared coincident with a complete posterior vitreous detachment. The MH was closed by vitrectomy with peeling of the internal limiting membrane. CONCLUSIONS: Optical coherence tomography identified an unusual ophthalmoscopic presentation of a preretinal opacity as a part of laminated vitreous cortex associated with a "can-opener" MH.
This technique manages vitreous prolapse associated with posterior capsule rupture during phacoemulsification by performing small-gauge pars plana vitrectomy with a sutureless, self-sealing incision performed in a closed chamber, maintaining normal intraocular pressure. A high-speed cutter exerts minimal traction on the vitreous. Accessibility to the vitreous through the pars plana is better, ensuring more complete removal of the vitreous and restoration of normal anatomy.