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A. Guillaubey, J.-P. Berrod, L. Malvitte, A. M. Bron, C. Creuzot-Garcher; Idiopathic Macular Hole Surgery Combined or Followed With Cataract Extraction: A Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4123.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the effects of two modalities of treatment for idiopathic macular hole (IMH) and cataract surgery on functional results: combined surgery versus successive surgeries.
A retrospective clinical trial was performed in two academic centers, to compare the functional results of the combined surgery and the successive treatment of IMH and phacoemulsification performed during the year after the initial IMH surgery. Forty eyes were included: twenty consecutive combined surgeries (group 1) and 20 consecutive IMH surgeries in phakic eyes (group 2). Exclusion criteria were: axial length > 26 mm and other causes of low visual acuity. Outcomes were the best corrected visual acuity (BCVA) 18 months after the initial surgery and the anatomic status of the IMH.
One anatomic failure occurred in each group with a persistence of the IMH but the second procedures were successful. The twenty phakic eyes benefited from a cataract extraction during the year following the first surgery. No serious complications were noted. Mean baseline BCVA was 1.12 and 0.83 logMAR in group 1 and 2 respectively (p=0.02). Mean final BCVA was 0.42 and 0.33 logMAR in group 1 and 2 respectively (p=0.12). The mean increase of VA was significant for both groups (p<0.01). The BCVA improvement was 0.73 logMAR in group 1 and 0.5 logMAR in group 2 (p=0.03).
IMH surgery induces cataract formation and most of patients have to benefit a cataract extraction within two years. Therefore some surgeons advocate a combined surgery. This technique seems to have the same anatomic success rate than the IMH surgery alone, without any additional complications. Final BCVAs after combined surgery and after successive procedures for IMH and cataract are not different. The combined surgery can avoid a second surgery and the decrease of visual acuity a few months after the IMH surgery.
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