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Functional and morphologic outcomes after reoperation for persistent idiopathic macular hole
Akira Hagiwara1, Takayuki Baba2, Tomoaki Tatsumi2
1Department of Ophthalmology, Teikyo University Chiba Medical Center, Chiba - Japan.
European Journal of Ophthalmology
|September 21, 2016
Summary
Second surgery successfully closed macular holes (MH) in all patients, significantly improving visual acuity. Postoperative visual outcomes depended on the ellipsoid zone (EZ) integrity, not initial factors.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Visual Outcomes Research
Background:
- Macular holes (MH) can persist after initial surgery.
- Understanding factors influencing visual recovery after repeat surgery is crucial.
Purpose of the Study:
- To investigate the relationship between preoperative/postoperative characteristics and visual outcomes.
- To identify predictors of success after a second surgery for unclosed macular holes.
Main Methods:
- Retrospective review of 166 eyes undergoing vitrectomy for MH.
- Analysis of 9 eyes requiring a second vitrectomy with internal limiting membrane (ILM) peeling.
- Evaluation of best-corrected visual acuity (BCVA), MH size, and optical coherence tomography (OCT) findings.
Main Results:
- All persistent MHs closed after the second surgery.
- Mean BCVA significantly improved post-second surgery (0.77 to 0.25 logMAR).
- Postoperative ellipsoid zone (EZ) integrity correlated with final BCVA, unlike baseline characteristics.
Conclusions:
- Repeat vitrectomy effectively closes persistent macular holes.
- Visual recovery is linked to postoperative retinal microstructural integrity (EZ status).
- Reduced microstructural recovery may explain suboptimal visual outcomes despite successful MH closure.
