Idiopathic macular holes are today treated surgically with good results. The prognostic value of factors predictive for the anatomical and functional outcome has not been completely evaluated.
Patients and methods: One hundred and thirty-five eyes with penetrating macular holes (stage II-IV) were investigated prospectively. The mean follow-up was 19.5 months (6-50 months).
Results: In 86% of cases the hole was closed postoperatively. The age of the macular hole proved to be a significantly predictive factor for the outcome; the age of the patient did not. The diameter of the hole showed no influence on the results. Application of autologous serum in front of the hole did not significantly improve the anatomical, but the functional results. The strongest improvement of visual acuity was seen in eyes with poor preoperative function. In 118 eyes a prefoveal membrane could be peeled off. Seventeen eyes without detectable membrane showed identical results.
Conclusion: Some predictive factors in macular hole surgery are proven, others remain uncertain. Identical results in eyes with and without prefoveal membranes support the assumption of different pathomechanisms in macular hole formation.