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P. W. Hasler, B. Braun, B. Sander, U. Schneider, M. Larsen, C. Pruente; Microperimetric Assessment of Macular Holes Before and After Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):760.
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To assess changes of the light increment sensitivity (LIS) and the fixation stability of the macula in patients with macular hole before and after macular hole surgery.
Twelves eyes of 12 patients were examined in a prospective, consecutive, non-comparative, interventional clinical case series. All eyes had full-thickness macular holes stage 2 to 4 and underwent pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling with trypan blue and fluid-air exchange. After macular hole surgery, patients were instructed to maintain limited face-down positioning for two days. Functional and morphological parameters of macular hole-closure and complications were evaluated by best corrected visual acuity (BCVA) testing, microperimetry (MP-1), optical coherence tomography (OCT) and biomicroscopic examination at baseline and after surgery at days 3, 7 and months 1 and 6.
Overall, 91.6% (11 eyes) of the macular holes showed closure on OCT three days after surgery. Mean sensitivities were at baseline 4.8 dB, after 3 and 7 days, after 1 and 6 months 5.9 dB, 6.1 dB, 7.4 dB and 7.5 dB respectively. Two degree fixation stabilities at baseline were 83%, after 3 and 7 days, after 1 and 6 months 86%, 99%, 87% and 93% respectively.
Our results suggest that functional recovery of macular structure after macular hole surgery already occurs during the first post surgical days, especially regarding the fixation stability. The light increment sensitvity increases slower.
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