Purpose
To identify pre- and intraoperative risk factors that predispose to outer retinal fluid development following successful macular hole surgery. The natural course of the foveal detachment was also investigated.
Methods
Thirty four eyes of 33 patients that underwent pars plana vitrectomy for idiopathic MH were studied. Best corrected visual acuity (BCVA), and Spectralis SD-OCT images were examined preoperatively and at 1, 3, 6 months postoperatively. Patients’ demographic characteristics, stage of macular hole and differentiation between surgeons regarding surgical technique were also recorded. Correlation between postoperative foveal detachment and the above possible explanatory variables were evaluated.
Results
Postoperative presence of outer retinal fluid was observed in 13/34 (38%) eyes. In 9/13 of those eyes foveal detachment disappeared by 6 months but one patient developed lamellar hole leading to full thickness MH 26 months following initial surgery. Preoperative BCVA was 0.55 ± 0.23 improving to 0.33±0.2 in the final follow up. Postoperative VA was better in eyes that did not developed postoperative foveal detachment (0.40 ±0.23 vs 0.32±0.20) but did not reach statistical significance (p=0.30). Development of postoperative foveal detachment was associated with preoperative foveal vitreomacular traction (p=0.048), stage II MH (p=0.017) and smaller size of the closest distance between the MH edges (p=0.046).
Conclusions
Postoperative foveal detachment is a common finding following successful MH surgery. Meticulous evaluation of preoperative clinical and OCT findings may disclose risk factors associated with this condition.
Keywords: 586 macular holes •
762 vitreoretinal surgery •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)