Macular hole surgery prognostic success rates based on macular hole size

Ophthalmic Surg Lasers Imaging. May-Jun 2012;43(3):184-9. doi: 10.3928/15428877-20120102-05. Epub 2012 Feb 9.

Abstract

Background and objective: To evaluate the correlation between macular hole (MH) surgery outcomes and preoperative factors believed to affect surgical success rates.

Patients and methods: A retrospective, consecutive case series was designed to evaluate the correlation between anatomic success and preoperative factors: MH duration prior to surgery, visual acuity (VA), and MH diameter measured by optical coherence tomography (OCT) at the base and the narrowest midpoint.

Results: A total of 153 eyes were enrolled. There was no significant difference in mean duration prior to surgery for MH success and failure (P = .13). Mean preoperative VA was significantly better for MH success than failure (P = .03). Mean mid-hole diameter (P < .001) and mean base-hole diameter (P < .001) were significantly less for MH success than failure. Failure rate was 0% among eyes with mid-hole diameter less than 500 microns and 14.9% with mid-hole 500 microns or greater (P < .001). Failure rate was 0% among eyes with base-hole diameter less than 500 microns, 1.4% with base-hole 500 to 999 microns, and 19.1% with base-hole of 1,000 microns or greater (P = .001).

Conclusion: Preoperative VA, mid-hole diameter, and base-hole diameter are correlated with anatomic success in MH surgery. An excellent surgical prognosis exists for MHs with mid-hole diameter less than 500 microns and base-hole less than 1,000 microns.

MeSH terms

  • Endotamponade*
  • Female
  • Fluorocarbons / administration & dosage*
  • Humans
  • Male
  • Prognosis
  • Prone Position
  • Pseudophakia / complications
  • Retinal Perforations / classification
  • Retinal Perforations / pathology*
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*

Substances

  • Fluorocarbons
  • perflutren