Should I repair my Lamellar Macular Hole?

Good Morning, I am 63 years old female. I did OCT for both eyes in 09/10/2019 which show right eye full thickness macular hole and left eye lamellar macular hole. The vision of my right eye is poor (less than 6/60) since my adolescence. It was corrected a little by glasses, but l have been told that this eye is a weak or lazy eye which could not be corrected fully. I did vitrectomy with phaco + IOL for this right eye in 20/10/2019 as a treatment for the full thickness macular hole. The vision in left eye with lamellar macular hole is good for the time being, (6/9) with no problems. I depend mainly on this eye for vision since childhood. I need consultation whether it is wise to operate on the left good eye to prevent any expected deterioration in vision of this eye, taking into consideration that I depend mainly on this eye for vision, or it is wise to wait and see and follow up this eye. I am afraid to postpone the operation till vision deteriorates in this left eye hence the outcome of the operation will not be satisfactory. Please find attached OCT for the eyes. Best regards

Answer:

Dear XXXXXX Based on the information that you provided, it would be a bad idea to operate on your left eye. Although occasionally a lamellar macular hole will progress to a full-thickness macular hole, this is unusual. It is probable that your lamellar hole in the left eye will not progress to a full-thickness macular hole. You should have a retina specialist locally to give you advice after examination, as this is nothing more than a consultation based on some pictures and your communicated history. There is a puzzling aspect to your email. You state that you received vitrectomy with phaco+ IOL for the right eye for treatment of a macular hole. This type surgery is not surgery for macular hole. Macular hole surgery is a vitrectomy, internal limiting membrane peel, and gas/fluid exchange. This leads me to believe that you and your ophthalmologist need to have better communication as to what was done to your right eye and for what purpose. In closing, I would recommend that you obtain a local retina specialist for a comprehensive evaluation. The advice that I am giving you via the Internet is limited by not examining you. Best of luck. Sincerely, David Browning MD