Long-Term Outcomes after Macular Hole Surgery.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Visual Outcomes

Background:

• Idiopathic full-thickness macular holes (MH) are a significant cause of vision loss.
• Pars plana vitrectomy (PPV) is a common surgical intervention for MH.

Purpose of the Study:

• To evaluate the long-term structural and visual outcomes following PPV for idiopathic MH.
• To assess the durability of visual improvement and anatomical restoration over at least 5 years post-surgery.

Main Methods:

• Retrospective case series including patients with idiopathic MH undergoing PPV.
• Best-corrected visual acuity (BCVA) was tracked preoperatively and up to 10 years post-surgery.
• Spectral-domain optical coherence tomography (SD-OCT) assessed ellipsoid zone (EZ) and external limiting membrane (ELM) integrity, and cystoid spaces.

Main Results:

• Postoperative BCVA improved significantly at all time points and remained stable up to 10 years.
• Successful MH closure was achieved in 94% of eyes, with an 8% reopening rate.
• Restoration of EZ and ELM integrity occurred in 60% and 62% of eyes, respectively.
• Better preoperative BCVA and postoperative ELM/EZ integrity correlated with superior final visual acuity.

Conclusions:

• Visual acuity improvement after MH surgery is sustained long-term.
• Final visual outcomes are influenced by preoperative visual acuity and postoperative OCT-derived structural integrity.
• PPV offers durable visual benefits for idiopathic MH.