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Luminita Tarita-Nistor, Esther G. González, Mark S. Mandelcorn, Linda Lillakas, Martin J. Steinbach; Fixation Stability, Fixation Location, and Visual Acuity after Successful Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(1):84-89. doi: 10.1167/iovs.08-2342.
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purpose. This study examined whether changes in fixation stability and fixation location are good predictors of visual acuity after successful macular hole surgery.
methods. Ten patients with macular hole were tested before surgery and at 1 and 3 months after surgery. Visual acuity was measured with the ETDRS; fixation stability and fixation location were assessed with the MP-1 Microperimeter (Nidek Technologies Srl., Vigonza, PD, Italy). The quantitative measure of fixation stability was calculated with a bivariate contour ellipse area (BCEA). Fixation location shift was evaluated using the differential map analysis feature of the MP-1 Microperimeter.
results. There was a significant improvement in visual acuity after macular hole closure. Fixation location shifted an average of 0.55 deg and 0.87 deg at 1 month and 3 months after surgery, respectively. The fixation shift was not a good predictor of visual outcome. Fixation stability improved from an average of 0.35 deg2 before surgery to 0.29 deg2 at 3 months after surgery. The change in fixation stability (ΔBCEA = BCEA before − BCEA after surgery) correlated highly with visual outcome. The regression model showed that ΔBCEA accounted for a significant proportion of the variance in visual acuity both 1 and 3 months after surgery.
conclusions. Some changes in ocular motor function explain the visual outcome after the anatomic success of macular hole surgery. Fixation location shift has no influence on visual acuity post-operatively; however, change in fixation stability is a strong predictor of visual outcome after successful closure of the macular hole.
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