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Updated: Dec 9, 2025

Iris Fixation via External Pentagram Suturing

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Published on: May 5, 2022

Macular hole closure patterns: an updated classification.

Tommaso Rossi¹, Daniela Bacherini², Tomaso Caporossi²

¹IRCCS Ospedale Policlinico San Martino - UOC Oculistica, Largo Rosanna Benzi 2, 16100, Genoa, Italy. tommaso.rossi@usa.net.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie

|September 10, 2020

Summary

This summary is machine-generated.

A new macular hole closure pattern (MHCP) classification based on retinal layer restoration accurately describes outcomes from novel surgeries. This classification correlates surgical techniques with visual results, improving patient care.

Keywords:

Amniotic membrane implant Autologous retina implant Autologous retinal transplantation Closure pattern Graft Human amniotic membrane Internal limiting membrane Macular hole Pars plana vitrectomy

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Area of Science:

Ophthalmology
Retinal Surgery
Optical Coherence Tomography

Background:

Current macular hole closure pattern (MHCP) classifications using time domain OCT or foveal contour are limited.
Existing classifications do not detail retinal layer reconstitution, which is crucial for understanding outcomes of advanced surgical techniques.

Purpose of the Study:

To introduce a novel MHCP classification system.
This new system aims to accurately describe all MHCPs resulting from modern surgical interventions by focusing on retinal layer restoration.

Main Methods:

Retrospective analysis of patients undergoing macular hole surgery using five distinct surgical techniques.
Classification of MHCPs was performed using spectral domain optical coherence tomography (SD-OCT).
A detailed typology (Type 0, 1, and 2 with sub-classifications) was established based on the status and integrity of retinal layers post-surgery.

Main Results:

A high closure rate of 95.2% was observed.
Significant correlation found between surgical technique, MHCP, and post-operative visual acuity (p < 0.001).
Type 1 MHCPs, particularly 1A and 1C, demonstrated superior visual outcomes compared to other types. Shifting closure patterns showed higher vision improvement.

Conclusions:

The proposed MHCP classification based on retinal layer restoration effectively encompasses diverse post-operative anatomical morphologies.
This classification system establishes a clear correlation between surgical techniques and achieved visual outcomes in macular hole repair.