BACKGROUND
Secondary full-thickness macular hole (FTMH) following rhegmatogenous retinal detachment (RRD) repair is an uncommon but recognized complication. Although epiretinal membrane (ERM)-related tangential traction has been implicated, postoperative macular hole formation can occur in a more complex postoperative setting.
CASE REPORT
A 71-year-old woman with blindness in the left eye due to untreated total retinal detachment presented with macula-off RRD in her only functional right eye. Best-corrected visual acuity (BCVA) was 20/50, and preoperative optical coherence tomography (OCT) revealed an ERM. She underwent 25-gauge pars plana vitrectomy with concomitant ERM/internal limiting membrane peeling, endolaser photocoagulation, and silicone oil tamponade. BCVA increased to 20/22 at 5 weeks postoperatively. Silicone oil was removed 7 weeks after surgery. OCT immediately before oil removal demonstrated a small foveal defect without cystoid macular edema (CME). Given the small size of the lesion, no additional intervention for macular hole closure was performed. One week later, OCT showed progression to an FTMH with concurrent CME and localized retinal detachment surrounding the hole. The hole was managed conservatively without reoperation. Serial OCT exhibited signs of closure at 3 weeks, with complete closure achieved by 5 weeks after oil removal followed by partial restoration of the outer retinal layers and a final BCVA of 20/30 at 13 weeks.
CONCLUSIONS
This report describes a case of a serial OCT-documented course from a small foveal defect before silicone oil removal to a transient postoperative FTMH with CME and localized retinal detachment, followed by spontaneous closure. In carefully selected patients with small postoperative macular holes without clear persistent traction and with anatomical stability, short-term OCT-based observation may be considered.

Keywords: Epiretinal Membrane; Macular Edema; Optical Imaging; Retinal Detachment; Silicone Oils; Vitrectomy