Sequential Management of Macular Hole–Associated Rhegmatogenous Retinal Detachment: Case Report and Literature Review
Bibliographic record
Abstract
Purpose: To present a sequential surgical approach for macular hole (MH)–associated retinal detachment using preoperative pneumatic retinopexy followed by pars plana vitrectomy, and to review the published literature on surgical strategies for this condition. Methods: A retrospective chart review was conducted for 2 patients who developed MH-associated retinal detachment. For the literature review, PubMed was used as the primary reference database to identify relevant studies. Results: Two patients with MH-associated retinal detachment were described. Both underwent pneumatic retinopexy to treat the retinal detachment, followed by pars plana vitrectomy with amniotic membrane plug or internal limiting membrane (ILM) peel, achieving successful MH closure. The literature review included 502 cases of MH-associated retinal detachment. Of these, 65% (333/502) were female and 90% were myopic. Fewer than 2% of patients underwent sequential repair of the retinal detachment and MH. In 7% of cases, laser photocoagulation was performed around the MH following vitrectomy. More than half the eyes underwent conventional ILM peel, with other techniques including ILM peel with insertion into the MH, ILM inverted and draped over or inserted into the MH, or amniotic membrane plug. The overall MH closure rate was 64%, and the initial retinal reattachment rate was 95%. Conclusions: We reviewed 2 cases that underwent a sequential surgical approach for the treatment of MH-associated retinal detachment, converting an emergent retinal detachment into an elective MH case and enhancing the likelihood of hole closure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".