The authors present a long-term course of a woman in her late 50s with persistent full-thickness macular hole (FTMH) after vitrectomy combined with internal limiting membrane peeling subsequently achieved MH closure after receiving topical therapy. Specifically, successful MH closure was observed at eight weeks following an initiation of topical nepafenac, prednisolone acetate, and carbonic anhydrase inhibitor (CAI). Thereafter, the patient was maintained on topical CAI only and achieved 20/32 vision OS with nearly complete restoration of ellipsoidal layers at 18 months postoperative. To conclude, topical therapy may be considered as a non-invasive approach for persistent, cystic, small-apertured MH after vitrectomy procedures. Continuous uses of topical CAI may be of value for sustaining the long-term results.

Keywords: Macular hole; Internal limiting membrane; Cystoid macular edema; Topical carbonic anhydrase inhibitor; Topical NSAID

DOI: 10.35755/jmedassocthai.2023.11.13907

Received 4 August 2023 | Revised 6 October 2023 | Accepted 24 October 2023