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Two-Year Anatomical and Functional Outcomes After Macular Hole Surgery: A Prospective, Controlled Study.

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    Macular hole surgery patients showed thinning in the retinal nerve fiber layer and ganglion cell layer two years post-operation. Larger retinal defects predicted better visual recovery after macular hole repair.

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    Area of Science:

    • Ophthalmology
    • Retinal Imaging
    • Surgical Outcomes

    Background:

    • Macular hole (MH) surgery aims to restore vision.
    • Understanding long-term anatomical and functional changes is crucial.

    Purpose of the Study:

    • To assess 2-year anatomical and functional outcomes following MH surgery.
    • To identify predictors of visual recovery after MH repair.

    Main Methods:

    • Spectral-domain optical coherence tomography (SD-OCT) was used to analyze retinal layers.
    • Measurements included retinal nerve fiber layer (RNFL), external limiting membrane (ELM), inner segment/outer segment (IS/OS) junction, cone outer-segment tips (COST) line, and ganglion cell inner plexiform layer (GCIPL) thickness.
    • Evaluations were performed preoperatively and at 3, 12, and 24 months postoperatively in 10 patients.

    Main Results:

    • Eyes undergoing MH surgery exhibited thinning in the inferior peripapillary RNFL and average GCIPL compared to the fellow eye.
    • A significant correlation was found between the size of defects in the ELM, IS/OS junction, and COST line and visual recovery.
    • Inferior peripapillary RNFL was thinner in the surgical eye (SE) (110 ± 12.2) versus the fellow eye (FE) (123 ± 9.82) (P < .05).

    Conclusions:

    • Macular hole repair is associated with long-term thinning of the inferior RNFL and GCIPL.
    • The size of ELM, IS/OS junction, and COST line defects are significant predictors of visual recovery after MH surgery.