Surgical management of full-thickness macular hole following Nd:YAG laser hyaloidotomy for pre-macular haemorrhage in a patient with anaemic retinopathy

Pre-macular haemorrhage (PMH) can cause profound visual loss. Some surgeons prefer neodymium-doped yttrium aluminium garnet (Nd:YAG) hyaloidotomy as the first line of treatment due to being an easy technique and having a high success rate. However, the use of high energy close to the fovea can lead to various macular complications. We present a case of a patient who presented with PMH secondary to anaemic retinopathy. He underwent Nd:YAG laser hyaloidotomy, but developed a full-thickness macular hole. He further underwent vitrectomy and a type 1 closure was achieved. However, the visual gain was poor due to the large hole size and the collateral thermal damage. The hole may not close spontaneously, thus requiring surgical intervention. The surgical outcome of these holes depends on the size of the hole and the collateral thermal damage caused during the laser procedure.