June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Anatomic and Visual Success after Macular Hole Surgery in an Asian population
Author Affiliations & Notes
  • Karen Chia
    Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore, Singapore
  • Hon Tym Wong
    Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore, Singapore
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5806. doi:
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      Karen Chia, Hon Tym Wong; Anatomic and Visual Success after Macular Hole Surgery in an Asian population. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5806.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To identify factors associated with anatomical and visual success of macular hole surgery in an Asian population.

Methods: A retrospective, interventional case series of 79 consecutive eyes with idiopathic senile full thickness macular holes treated by pars plana vitrectomy (PPV) were analysed.

Results: The median follow-up time was 19.5 months. The mean age was 63.4 years (range 36-82 years) and there were more females (64.6%). Anatomical success was achieved in 78.5% of eyes after 1 surgery. Best corrected visual acuity (VA) improved from a median of LogMAR of 0.88 to 0.48 at last follow up. Thirty-seven eyes (46.8%) had final VA of 20/40 or better. Sixty-two (78.5%) holes were closed after 1 surgery. Internal limiting membrane (ILM) peel was performed in 70 eyes (88.6%), of which 26 had no stain and staining was used in 44 eyes (55.7%). Trypan blue was the most common stain used (35 eyes, 79.5%). Cataract, epiretinal membrane formation and high IOP were the most common complications of surgery. Hole closure correlated well with final BCVA 20/40 or better (p= 0.011, Chi-square with continuity correction, OR=7.5). Anatomical closure correlated with improvement of at least 3 lines (p=0.024) but not duration of symptoms (p=0.069). The main factors predictive for hole closure was performing an internal limiting membrane peel (p= 0.002). Pre-operative hole diameter (≤400μm) was predictive for good final VA (p=0.003), but was not correlated with anatomical closure (p=0.099). Patients with poor preoperative vision had higher likelihood of visual improvement of 3 lines or more (p=0.002) but duration of symptoms 1 year or more correlated with poor final VA (p=0.004). Final VA correlated closely with hole diameter (p=0.002) but not base diameter (p=0.253). The type of gas used, posturing technique and gauge of vitrectomy had no statistical effect on outcomes.

Conclusions: There was good success rates of macular hole surgery in Asians. Anatomic success was associated with ILM peel with stain. Pre-operative hole diameter (≤400μm) was predictive for good final VA.

Keywords: 586 macular holes • 762 vitreoretinal surgery • 754 visual acuity  
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