Biomicroscopic study of the vitreous in macular breaks.

The vitreous in 74 eyes with macular breaks was studied using the El Bayadi-Kajiura preset lens mounted on a slit lamp. Fifteen of the eyes had macular breaks secondary to various causes, and 59 eyes had idiopathic senile macular breaks. Vitreous traction, indicated by the presence of opercula or visible vitreous strands, was present in 29 (49%) of the idiopathic cases. In 17 of 31 eyes without posterior vitreous detachment (PVD), an operculum was seen. In these eyes, intravitreous traction was suspected to be the cause of macular breaks. Opercula were seen attached to the posterior hyaloid membrane in six of the nine eyes with partial PVD. An operculum corresponding to the macular break was observed on the posterior hyaloid membrane in only five of 19 eyes with complete PVD. Of the 15 eyes with macular breaks secondary to various causes, complete PVD was seen in 10 eyes, one of which had an operculum. One eye had no PVD, and four eyes had partial PVD. Opercula were detected in two of the latter eyes. In one eye of the senile group and one eye of the secondary group, partial PVD caused traction at the edges of the macular break, resulting in retinal detachment.