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Combined, consecutive cataract and macular hole procedures improve visual acuity
Am J Ophthalmol. 2010;150(3):387-391.
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Combined and consecutive macular hole surgery and cataract extraction have similar results, a study showed.
"Both combined and consecutive surgeries are safe and effective methods to treat macular hole and cataract with equivalent functional and anatomic results in both procedures," the study authors said. "However, combined surgery shortened the delay for visual recovery."
The retrospective multicenter study included 120 eyes of 120 patients with idiopathic macular hole and cataract; 64 patients underwent combined surgery and 56 underwent consecutive surgery. Mean patient age was 71 years.
Patients with macular hole secondary to trauma or associated retinal detachment, diabetic retinopathy, glaucoma, age-related macular degeneration, more than 6 D of myopia and preoperative pseudophakia were excluded.
Macular hole surgery involved pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. Cataract surgery was performed within 1 year after macular hole surgery in the combined procedure group.
Primary outcome measures were near and distance visual acuity before surgery and at 6 and 12 months after surgery. Optical coherence tomography was used to assess the rate of hole closure at 1 and 12 months.
Study results showed statistically significant improvements in near and distance best corrected visual acuities in both groups at 12 months (P < .0001). However, improvement in distance BCVA was statistically insignificant in the consecutive surgery group and statistically significant in the combined surgery group.
The combined surgery group had a hole closure rate of 100% and the consecutive surgery group had a closure rate of 96%. The difference was statistically insignificant. Data showed no statistically significant between-group differences in complication rates.