Silicone oil microbubble found in failed full-thickness macular hole closure.

PURPOSE:To describe a case of failed macular hole closure after vitrectomy with silicone oil tamponade because of a silicone oil microbubble. METHODS:This is a retrospective case review of a single patient's clinical course. RESULTS:Because of the inability of the patient to assume a prone position after vitrectomy for full-thickness macular hole, 1000-centistoke silicone oil tamponade was used at the initial repair. Optical coherence tomography showed persistent full-thickness macular hole with evidence of a silicone oil microbubble within the macular hole. Subsequent vitrectomy with the removal of silicone oil and exchange for 25% sulfur hexafluoride (SF6) gas with attempted prone positioning failed to provide hole closure. Successful hole closure was accomplished after tamponade with 5000-centistoke silicone oil, without prone positioning. No recurrence of the full-thickness defect was seen after the eventual removal of 5000-centistoke silicone oil. CONCLUSION:It is possible that the silicone oil microbubble formation and migration within a full-thickness macular hole defect may contribute to surgical failure.