Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization

Area of Science:

• Ophthalmology
• Retinal Surgery

Background:

• Macular hole (MH) repair is a common retinal surgery.
• Internal limiting membrane (ILM) peeling is crucial for successful MH closure.
• Triamcinolone acetonide (TA) can be used to visualize the ILM during surgery.

Purpose of the Study:

• To assess the long-term anatomical and visual outcomes of macular hole (MH) repair using triamcinolone acetonide (TA) for internal limiting membrane (ILM) visualization.
• Evaluate the safety and efficacy of this technique in a tertiary care setting.

Main Methods:

• Retrospective review of 78 eyes undergoing MH repair with TA-assisted ILM peel, gas tamponade, and facedown positioning (2014-2020).
• Analysis of pre- and post-operative visual acuity (VA), intraocular pressure (IOP), and anatomical closure via optical coherence tomography (OCT).

Main Results:

• High anatomic closure rate (94% overall, 97% excluding pathologic myopia, 100% for Stage 2/3 MHs).
• Significant visual acuity improvement from 20/187 to 20/91 logMAR (p < 0.0001).
• Recurrence in 17% of eyes, associated with pathologic myopia and cystoid macular edema; cataract progression in 96% of phakic eyes.

Conclusions:

• Macular hole repair utilizing TA for ILM visualization offers safe and effective long-term outcomes.
• Sustained visual acuity gains are observed post-surgery.
• Pre-existing glaucoma may progress, and recurrence is linked to specific ocular conditions.