Abstract
Purpose :
To assess long-term visual and anatomical outcomes following surgical repair of idiopathic full thickness macular holes (FTMH) with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peel in patients with 5 to 9 years of post-operative follow up
Methods :
A retrospective study evaluated patients diagnosed with idiopathic full thickness macular hole who received surgical repair at a single academic tertiary center with at least 5 years of post-operative follow up. Data collection included demographic and pre-operative characteristics including best visual acuity (BVA), lens status, prior ocular history, and macular hole structural integrity as determined by spectral domain optical coherence tomography (OCT). Surgical techniques along with functional and structural improvement were assessed by collection of BVA and findings of ellipsoid zone (EZ) integrity and intraretinal fluid (IRF) on OCT at determined time points of 3 months, 6 months and each year until 9 years of follow up.
Results :
The study comprised 90 eyes of 80 patients with a mean age of 67.2 +/- 6.8 years with an average post-operative follow up of 80.8 +/- 17.5 months (range 54-130 months). 61 eyes out of 70 phakic eyes (87%) received cataract surgery at the time of FTMH repair, with the remaining eyes receiving cataract surgery at an average of 9.5 +/- 4.6 months (range 5-18 months) post-surgery. Macular hole reoperation occurred in 4 eyes (4%) at a mean duration of 6.1 +/- 6.0 months (range 1-13 months). Over the study duration, EZ integrity was restored in 78% of eyes, with an absence of IRF in 96% on OCT. The pre-operative mean ETDRS BVA of 51 (Snellen equivalent 20/80-20/100) improved to a mean BVA of 76 (Snellen equivalent 20/25-20/30) at 5 years post operation, with an average gain of 25 letters at 1 year that remained stable over 5 years (P<0.05). >80% of eyes achieved a BVA > 65 (Snellen equivalent 20/50) 8 years after surgical repair.
Conclusions :
Vitreoretinal surgery for idiopathic FTMH resulted in successful hole closure and sustained visual acuity improvement over long-term follow up.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.