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Restoration of macular structure as the determining factor for macular hole surgery outcome
José Maria Ruiz-Moreno1, Francisco Lugo, Javier A Montero
1Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain. josemaria.ruiz@uclm.es
Objective:
The aim of this work is to evaluate the preoperative and postoperative spectral domain optical coherence tomography (SD-OCT) findings as predictors of visual acuity for macular hole (MH) surgery.
Methods:
Fifty eyes of 46 patients diagnosed with MH and that had undergone 25-g vitrectomy with internal limiting membrane peeling were included in this retrospective study. A complete clinical examination and SD-OCT were performed before and after surgery. Three groups were considered on the basis of the postoperative integrity of photoreceptor inner and outer segment (IS-OS) junction and the external limiting membrane (ELM): group A (11 eyes, both lines disrupted), group B (ten eyes, disrupted IS/OS line and complete ELM), and group C (29 eyes, both lines restored).
Results:
LogMAR BCVA improved significantly after surgery from an average 0.60 ± 0.29 to 0.19 ± 0.19 (p < 0.01). No significant differences had been detected preoperatively among these groups (p≥0.18). Postoperative BCVA was significantly better in group C compared to groups A and B (p ≤ 0.01). A significant correlation was found between ELM restoration and postoperative BCVA (r = -0.63, p < 0.01), as well as between IS/OS line restoration and postoperative BCVA (r = -0.55, p < 0.01).
Conclusions:
Outer retina restoration seems to be the best determining factor for a good visual rehabilitation after MH surgery.
