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T. Kube, D.T. Bragason, L.L. Hansen; Macular Hole Surgery and Adjuvants: Long Term Functional and Structural Results With Optical Coherence Tomography . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5191.
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The long term outcome of macular hole surgery is determined by slow retinal regeneration and subsequent cataract formation. Long term results and effects of autologous blood or autologous platelets concentrate as intraoperative adjunct were assessed.
In a randomized clinical trial macular hole surgery was performed on 67 idiopathic full thickness macular holes of 67 patients (F/M: 46/21). We compared the outcome of macular hole surgery with and without the aid of intraoperative adjunctive autologous blood or autologous platelets concentrate. Optical coherence tomography was performed to assess the anatomical outcome. Eyes were followed for 4,9 ± 1,2 years to assess visual function and optical coherence tomography was performed to determine anatomic status.
Both surgical groups had an overall anatomical restoration rate of 73.2% (49/67), with 62% of eyes achieving a visual acuity of 0.4 logMAR or better. A significant reduction of logMAR was achieved in 54%. The use of autologous serum or autologous platelets did not affect anatomic or visual results. A second operation for persistent macular hole was necessary was in 8 eyes (11,1%). A third operation was performed in 1 eye. At 4,9 years, 55 (82,1%) of all eyes had undergone cataract extraction.
Surgery for macular hole is safe and effective and is associated with significant visual improvement. Cataract formation is a frequent complication. Our findings suggest hat application of different autologous adjuvants does not enhance the results of surgery.
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