PERSISTENT SUBRETINAL FLUID AFTER VITRECTOMY FOR MACULAR HOLE-ASSOCIATED RETINAL DETACHMENT.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Macular Hole Surgery

Background:

• Macular hole-associated retinal detachment (MHRD) requires surgical intervention, typically vitrectomy.
• Persistent subretinal fluid (SRF) can complicate the postoperative course after MHRD surgery.
• Understanding factors influencing SRF is crucial for managing patient outcomes.

Purpose of the Study:

• To determine the incidence of persistent subretinal fluid (SRF) following vitrectomy for MHRD.
• To identify factors associated with the development of persistent SRF.
• To evaluate the visual outcomes in patients with persistent SRF.

Main Methods:

• Analysis of 158 eyes from 156 patients who underwent vitrectomy for MHRD and achieved macular hole closure.
• Definition of persistent SRF as fluid present for >1 month post-surgery.
• Statistical analysis of preoperative and postoperative parameters, including internal limiting membrane inverted flap, symptom duration, tamponade, and MHRD subtype.

Main Results:

• Persistent SRF occurred in 12.0% of eyes (19/158).
• Internal limiting membrane inverted flap was the only factor significantly associated with persistent SRF (OR, 15.778; P = 0.001).
• No significant difference in visual acuity improvement was observed based on foveal involvement or SRF absorption status.

Conclusions:

• Persistent SRF after MHRD surgery may be more challenging to resolve than in other retinal detachments.
• The presence of an internal limiting membrane inverted flap is a key risk factor for persistent SRF in MHRD.
• The final visual outcome appears independent of persistent SRF resolution in MHRD cases.