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Janet Manalac, John Frisbee, D Anthony Mazzulla; Outcomes of Idiopathic Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3333.
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The present study was performed to investigate the surgical findings and outcomes after vitrectomy for full-thickness macular hole.
Case records of 19 patients (19 eyes) who underwent vitrectomy for visually symptomatic macular hole in a 2 year period up to July 2012 were reviewed. All patients underwent vitrectomy and internal limiting membrane (ILM) peeling with staining by indocyanine green (ICG) dye. Intraoperative and postoperative complications were documented, and preoperative and final postoperative best-corrected visual acuities (BCVA) were recorded at periods of 1-4, 5-8, 9-12, and 13-24 months postoperatively. When necessary for the statistical analysis, data were transformed to logMAR format. Postoperative OCT to evaluate for macular hole closure was performed in the majority of patients and compared with preoperative findings.
Surgery was performed on 19 eyes of 19 patients. Patient follow-up ranged from 2 weeks to 24 months, with a mean duration of 9 months. Visual acuity improved postoperatively in 17 of 19 (89%) patients, with a mean improvement of >3 Snellen lines which was statistically significant at periods of four and twelve months postoperatively (p= 0.034 and 0.029 respectively by the single factor ANOVA test). Preoperative and postoperative OCT images were obtained in 18 of 19 eyes (95%) and were judged to have improved or normalized in 16 of 18 (89%) of these patients.
In our series of 19 patients, vitrectomy in general was found to be beneficial with regard to both visual acuity and anatomic (OCT) foveal appearance in the majority of patients. The few patients that did not show visual or anatomic improvement after surgery had chronic macular holes and proliferative vitreoretinopathy, factors that are recognized as important predictors of anatomical and visual success in macular hole surgery.
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