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G. Besozzi, F. Boscia, R. Provenzano, L. Sborgia, N. Recchimurzo, C. Furino, G. Sborgia, N. Cardascia, A. Montepara, C. Sborgia; Microperimetric Outcomes After 25-G Pars Plana Vitrectomy for Stage III/IV Macular Hole: A Prospective Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2556. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate tomographic results, visual acuity (VA) and microperimetric outcomes after 25-g pars plana vitrectomy (25gPPV) for stage III/IV macular hole (MH)
Ten eyes of 10 patients with stage III/IV MH underwent 25gPPV with ICG-assisted ILM peeling. They were evaluated at baseline, and at 1 and 3 months postoperatively. Anatomical outcomes were evaluated by spectral domain OCT (SDOCT) (RTVue-100, Optovue Inc, Freemont CA, USA). Functional outcomes were evaluated by measuring visual acuity (VA) and retinal sensivity, fixation point stability (2° and 4°) by microperimetry (MP1, Nidek Technologies, Padova, Italy).
All the MHs were closed and flat at the end of follow-up, as confirmed by SDOCT. VA was significantly improved from baseline (0.97±0.35 Log MAR) at month 1 and 3 (0.58±0.33 and 0.51±0.31 LogMAR respectively; p<0.001). Retinal sensitivity did not improve significantly from baseline to month 1 (from 9.52±2.63 dB to 9.51±3.6 dB, p=0.98), but it was significant at month 3 vs baseline (12.29±3.45 dB vs 9.52±2.63 dB, p=0.006) and vs month 1 (12.29±3.45 dB vs 9.51±3.6 dB, p=0.039). Fixation stability into the central 2° did not change significantly at any point, Fixation stability into the central 4° improved significantly at month 3 vs baseline (97% vs 88%, p=0.01) and vs month1 (97% vs 92%, p=0.049). At baseline, the fixation point was located in all eyes at the edge of the hole, superonasally. After surgery the fixation point shifted centripetally toward the foveal center.
Successful surgery for stage III/IV MH lead not only to VA improvement, but also to retinal sensitivity and fixation stability improvements and to the restoration of foveal fixation.
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