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Updated: May 23, 2025
An “All-laser” Endothelial Transplant
Published on: July 6, 2015
CHARACTERISTICS AND SURGICAL OUTCOMES OF LASER-INDUCED FULL-THICKNESS MACULAR HOLES
Ying Cui1, Wu Liu1, Yaxing Wang2
1Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China ; and.
Purpose:
To report the characteristics and the surgical outcomes of full-thickness macular holes (MHs) accidently caused by laser devices and analyze the visual predictors.
Methods:
Thirty-three eyes that underwent vitrectomy for laser-induced MHs were included. Full ophthalmic examinations and optical coherence tomography were used for assessment at baseline and at follow-ups. Preoperative and 6 months postoperative features were analyzed, respectively, as potential predictors of final visual acuity (VA).
Results:
Eleven eyes were injured by a neodymium-doped yttrium aluminum garnet laser and 22 by a handheld laser. Five of 33 eyes had a focal subfoveal choroidal depression preoperatively. Macular hole closure was achieved in 87.9% eyes. In total, 79.3% eyes had VA improvement of two or more lines. Compromised VA improvement was associated with preoperative choroidal depression (P = 0.026, odds ratio = 0.068, 95% confidence interval [CI]: 0.006-0.729). Worse final best-corrected visual acuity was associated with worse preoperative best-corrected visual acuity (P = 0.001, regression coefficient [B] = 0.497, 95% CI: 0.221-0.774), preoperative choroidal depression (P = 0.014, B = 0.353, 95% CI: 0.078-0.628), neodymium-doped yttrium aluminum garnet laser injury (P = 0.030, B=-0.244, 95% CI: -0.461 to -0.026), larger MH diameter (P = 0.023, B = 0.031, 95% CI: 0.005-0.058), failed MH closure (P = 0.003, B=-0.472, 95% CI: -0.775 to -0.169), larger ellipsoid zone defect at 6 months (P = 0.002, B = 0.053, 95% CI: 0.024-0.082), and thinner foveal neuroretina thickness at 6 months (P < 0.001, B=-0.365, 95% CI: -0.520 to -0.211).
Conclusion:
Vitrectomy is effective in closing laser-induced MHs and improving VA. Preoperative factors including worse preoperative best-corrected visual acuity, choroidal depression, neodymium-doped yttrium aluminum garnet laser injury, and larger MH diameter and postoperative factors including failed MH closure, larger ellipsoid zone defect, and thinner foveal neuroretina at 6 months are predictive factors for worse final VA.
