Author: Christophe Pinto (Portugal)
Co-authors: Luís Mendonça, Gil Calvão Santos, Rita Gentil, Nuno Gomes, Keissy Sousa
Idiopathic macular hole (MH) is a disease from the vitreoretinal interface whose treatment is surgical and requires pars plana vitrectomy (PPV). This study aims to evaluate which clinical factors may be predictors of anatomical and functional success after PPV in patients with idiopathic MH.
Department of Ophthalmology, Hospital de Braga, Braga, Portugal.
This retrospective study included patients aged ≥ 45 years with idiopathic MH submitted to primary PPV in a tertiary Portuguese ophthalmology department. The minimum postoperative follow-up time was 6 months. The main outcomes were the anatomical success defined by the complete closure of MH and the functional success defined by the postoperative best-corrected visual acuity (BCVA). The parameters evaluated included age, gender, preoperative BCVA, MH size, time until surgery, surgical technique, presence of epiretinal membrane (ERM), or presence of posterior hyaloid attachment.
A total of 67 eyes of 67 patients were included. The mean time until surgery was 88,0 ± 118,0 days. The surgical technique employed was internal limiting membrane peeling in 22 (32,8%) eyes, inverted flap in 37 (55,2%) eyes and internal limiting membrane transplant in 8 (11,9%) eyes. Preoperative BCVA was 1,00 ± 0,60 logMAR and postoperative BCVA was 0,60 ± 0,60 logMAR (p<0,001). Anatomical success was achieved in 71,4% patients. None of the variables – age (p=0,15), gender (p=0,93), preoperative BCVA (p=0,24), MH size (p=0,13), time until surgery (p=0,44), surgical technique (p=0,63), concomitant ERM (p=0,77), or posterior hyaloid attachment (p=0,25) – were predictors of anatomical success. The preoperative BCVA was the only predictive factor for postoperative BCVA (p<0,001). None of the variables – age (p=0,15), gender (p=0,41), MH size (p=0,25), time until surgery (p=0,28), surgical technique (p=0,07), concomitant ERM (p=0,19), or posterior hyaloid attachment (p=0,08) – were predictors of functional success.
PPV is anatomically and functionally efficient for the treatment of MH leading to structural and functional recovery of the retina. The baseline BCVA was found to be the main predictive factor of functional success in patients with MH submitted to PPV.
This research received no financial support. The authors declare no financial, institutional nor commercial interests related to the research.