Smaller hole diameter a factor in successful macular hole repair

Preoperative factors that appear to favorably affect the outcome of macular hole repair are mid-hole diameter less than 500 µm and base-hole diameter less than 1,000 µm, according to a study.

Preoperative visual acuity was also found to be a statistically significant prognostic factor (P = .03).

The retrospective case series examined 153 eyes of 144 consecutive patients. Thirteen eyes had macular hole stage 2, and 140 eyes had macular hole stage 3 or stage 4.

One surgeon performed all pars plana vitrectomy surgeries to repair the macular holes. Patients were examined at 1 day, 1 week, 1 month and 3 months postoperatively.

Optical coherence tomography showed that macular hole closure was successful in 143 eyes, while 10 eyes failed to close within 3 months.

There was a 0% failure rate in eyes with mid-hole diameter less than 500 µm and a 14.9% rate in eyes with mid-hole diameter of 500 µm or more (P < .001). There was a 0% failure rate in eyes with a base-hole diameter less than 500 µm, a 1.4% rate in eyes with base-hole diameter of 500 µm to 999 µm and a 19.1% rate in eyes with base-hole diameter of 1,000 µm or more (P = .001).

“Our results suggest anatomic success rates of approximately 85% for [macular holes] with mid-hole diameter 500 µm or greater and 81% for [macular holes] with base-hole diameter 1,000 µm or greater,” the study authors said.

Mean preoperative logMAR visual acuity in successful repair was 0.94 ± 0.51, whereas mean preoperative logMAR visual acuity in unsuccessful repair was 1.30 ± 0.66.

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Source:

Ophthalmic Surg Lasers Imaging. 2012;43(3):184-189.