[Macular morphologic reconstruction and visual recovery in patients following macular hole surgery]

To examine the characteristics of retinal reconstruction at the macula following macular hole surgery and to assess the impact of postoperative macular morphological changes on the visual outcome.

A prototype of the scanning retinal thickness analyzer (RTA) was used to obtain optical section images at the macula in 53 eyes of 52 patients who underwent macular hole surgery between April 1994 and July 1997. The mean age of participants was 64.7 years. At the time of RTA examination, macular hole was biomicroscopically closed in 49 eyes (91%) and unclosed in 5 eyes (9%).

There were 5 types of cross-sectional images of postoperative maculae: normal foveal depression [19 eyes (36%)], crater-like fovea formation [12 eyes (22%)], flattened fovea [8 eyes (15%)], fovea with abraded retinal pigment epithelium [9 eyes (17%)], and persistant macular hole [5 eyes (9%)]. Central macular thickness measured by RTA was 165 +/- 39 (mean +/- standard dereation) microns in the normal foveal depression group, 210 +/- 67 microns in the crater-like fovea formation group, and 300 +/- 50 microns in the flatened fovea group. There were statistically significant differences (p < 0.01) between groups. Postoperative visual acuity was significantly different (p < 0.01) between these three groups, and central macular thickness was highly correlated with postoperative visual acuity (R = 0.70).

Visual recovery following macular hole surgery is closely associated with the retinal reconstruction at the macula.