Intentional use of topical latanoprost with resulting macular edema to help in the closure of a failed, chronic, macular hole

PURPOSE: To report a case where the induction of macular edema with topical latanoprost coupled with in-office gas injection effectively sealed a persistent, chronic, macular hole. OBSERVATIONS: A 70-year-old, pseudophakic, patient presented with a stage three, chronic, macular hole (MH) and vision reduced to 20/200. The symptoms had been present for 18 months. Patient had surgery with pars plana vitrectomy (PPV), complete internal limiting membrane (ILM) peel to the arcades, 30% SF(6) gas, and excellent face down positioning for five days. Two weeks after surgery the macular hole failed to close, and the edges of the hole were blunted with very little retinal edema and vision reduced to 20/400. The patient did not want to go back to the operating room. After informed consent, the patient was started on topical latanoprost 0.005% on the operative eye twice a day for six weeks. After latanoprost induction of cystoid macular edema (CME), the patient had 0.7 cc of pure C(3)F(8) injected into the vitreous cavity in the office and was instructed to be face down for five days. Two weeks later the macular hole was closed with vision of 20/80. Last corrected vision eight months later was 20/50. CONCLUSIONS AND IMPORTANCE: The findings in this case suggest that induction of CME facilitated the closure of a chronic, persistent, macular hole with a simple gas injection in the office and face down positioning for five days.