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Zhongcui Sun; Comprehensive Retinal Anatomical And Functional Evaluation Before And After 23-gauge Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1052.
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To evaluate the anatomical and functional prognosis of idiopathic macular hole (IMH) patients who received standard pars plana vitrectomies (PPVs) and to analyze the roles of the MP1 microperimetry and the multifocal electroretinogram (mfERG) in the evaluation of pre- and postoperative visual functions.
Twenty-seven eyes of 25 IMH patients were included. Each eye received standard PPV with internal limiting membrane (ILM) peeling and intraocular gas tamponade, with or without phacoemulsification and intraocular lens implantation. Best corrected visual acuity (BCVA) evaluation, optic coherent tomopgraphy (OCT) scans, MP1 microperimetry, and mfERG tests were performed on each operated eye pre- and 6 months postoperatively.
Comformable variations were found among BCVA, MP1 outcomes, and mfERG of inner three rings. Compared to preoperative statuses, improvements were found in BCVA, MP1 results, and mfERG N1 and P1 amplitudes in ring 2 and 3. Hole size was negatively correlated with BCVA, retinal sensitivity, and mfERM P1 amplitudes in ring 1 and 2, but did not predict anatomical restoration of holes. Postoperatively, photoreceptor inner and outer segment (IS/OS) continuity provided better BCVA and minor central scotoma, while foveal attachment proved higher retinal sensitivity and more stable and central fixation. Visual function improvements in eyes undergoing cataract surgeries did not show significant difference from eyes that remained phakic postoperatively.
Standard PPVs with ILMs peeling, rather than combined cataract surgery, contributed to the visual function restoration in IMH eyes. Mere BCVA was not enough for an adequate interpretation of OCT results or for patients' actual visual function. Additional methods might be advisable, such as the MP-1 microperimetry and the mfERG which matched functional results well with anatomical features illustrated by OCT, thus affording a more comprehensive visual function both pre- and postoperatively.
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