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Microperimetry as a Sensitive Tool for Assessing Functional Outcomes after Idiopathic Macular Hole Surgery
Aims:
To evaluate changes in retinal sensitivity and fixation parameters in patients with idiopathic macular hole using microperimetry before surgery and 3 months after pars plana vitrectomy with internal limiting membrane (ILM) peeling.
Material And Methods:
This prospective study included 11 eyes of 11 patients. All patients underwent 25-gauge pars plana vitrectomy with conventional circular ILM peeling extending approximately 2-3 optic disc diameters around the macular hole and SF6 gas tamponade. Best-corrected visual acuity (BCVA), retinal sensitivity measured by MAIA microperimetry, and fixation parameters (P1, P2, BCEA 63% and BCEA 95%) were evaluated. Microperimetry was performed preoperatively and 3 months postoperatively. The Wilcoxon signed-rank test was used for paired comparisons, the Mann-Whitney U test for subgroup analysis, and Spearman's rank correlation coefficient for correlation analysis.
Results:
The mean age was 67.2 ±7.6 years; the cohort included 9 women and 2 men. Anatomical closure of the macular hole was achieved in all eyes. BCVA improved from 0.31 ±0.11 to 0.67 ±0.22 (p = 0.001). One patient was excluded from the primary microperimetry analysis because of postoperative cataract progression. In the remaining 10 eyes, mean retinal sensitivity increased from 16.72 ±4.48 to 19.68 ±4.27 dB (p = 0.006). No statistically significant changes were observed in the fixation parameters. The improvement in retinal sensitivity was numerically greater in larger macular holes (>400 µm; 3.97 vs. 1.95 dB; p = 0.222). A statistically significant inverse correlation was observed between macular hole size and baseline retinal sensitivity (ρ = -0.83; p = 0.003).
Conclusion:
Microperimetry represents a valuable complementary method for evaluating functional outcomes after idiopathic macular hole surgery. It enables the detection of changes in macular retinal sensitivity that may not be fully reflected by BCVA alone. In our cohort, both visual acuity and retinal sensitivity improved significantly after surgery, whereas fixation parameters showed no statistically significant change.
