Abstract
Purpose :
To report the characteristics and the visual and anatomical outcomes of surgically treated full-thickness macular holes (MHs) accidentally caused by laser devices and analyse the visual predictors.
Methods :
All 28 consecutive patients who underwent vitrectomy for laser-induced MHs at Beijing Tongren eye center from August 2013 to April 2023 were included. The minimum follow-up time after surgery was 6 months. A full ophthalmic examination and optical coherence tomography (OCT) were used for assessment at baseline and at follow-ups.
Results :
11 patients were accidentally injured by an yttrium aluminum garnet (YAG) laser and 17 by a handheld laser. The MH minimum diameters (MDs) ranged from 218 to 1152μm (mean, 525.0 ± 227.0μm). 5 patients had a focal subfoveal choroidal depression preoperatively. Preoperative bestcorrected visual acuity (BCVA) was associated with preoperative MD (P=0.021, B=0.040, 95%CI: 0.007~0.073). BCVA improved from 0.846 ± 0.370 logMAR preoperatively to 0.523 ± 0.443 logMAR postoperatively (P<0.001, t =4.192). MH closure was achieved in 89.3% eyes. Visual acuity (VA) improvement of at least 2 lines of Snellen’s visual acuity was observed in 65.2% eyes. VA improvement was associated with preoperative choroidal depression (P=0.035, OR=0.071, 95%CI: 0.006~0.834). Final VA (logMAR) was associated with preoperative choroidal depression (P=0.020, B=0.507, 95%CI: 0.090~0.924), preoperative BCVA (P=0.002, B=0.719, 95%CI: 0.284~1.153), final MH closure status (P=0.012, B=-0.664, 95%CI: -1.163~-0.164), postoperative ellipsoid zone (EZ) defect (P=0.017, B=0.054, 95%CI: 0.012~0.097) and postoperative foveal thickness (P=0.003, B=-0.439, 95%CI: -0.666~-0.213).
Conclusions :
Vitrectomy is effective in closing laser-induced full-thickness MHs and improving visual acuity. Preoperative choroidal depression, worse preoperative VA, failed MH closure, greater postoperative EZ defect and thinner postoperative foveal thickness are predictive factors for worse final VA.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.