Results of macular hole surgery combined with PEA and IOL

We evaluated the factors affecting closure and postoperative visual acuity, as well as complications among idiopathic macular hole surgery cases comprising 631 eyes in 576 patients. Almost all the surgeries were combined with simultaneous intraocular lens surgery (triple surgery). In some cases, the standard method was accompanied by internal limiting membrane peeling around the macular hole or abrasion of retinal pigment epithelium at the base of the macular holes. We found that male gender and short eye axial length were associated with closure and postoperative visual acuity. Although the frequency of peripheral retinal tears during surgery was high, the frequency of postoperative retinal detachment was less than 2%. The reopening frequency was about 5% among all cases, and was highest among eyes that underwent the abrasion method. There were no other significant complications. Internal limiting membrane peeling is effective for treatment of cases with unfavorable preoperative conditions. However, the standard method is sufficiently effective for cases with favorable preoperative conditions. Further analysis is required to evaluate postoperative visual function by methods other than visual acuity. Further study of internal limiting membrane peeling, as a treatment alternative, is also required.