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Preop base diameter may be associated with success of macular hole closure
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Preoperative base diameter measurements may predict the anatomical and visual outcomes of macular hole surgery, according to a study.
A retrospective review analyzed 50 eyes of 50 consecutive patients with idiopathic stage 2, stage 3 or stage 4 macular hole. All patients were operated on by the same surgeon, with a follow-up of at least 3 months.
Patients were examined postoperatively at 2 weeks, 6 weeks and 3 months with fundus microscopy and optical coherence tomography imaging to assess macular hole closure. Best corrected visual acuity, stage of macular hole and axial length were analyzed both preoperatively and postoperatively.
All patients underwent vitrectomy and phacoemulsification with IOL implantation. Macular hole closure was successful in 42 patients.
Base diameter (P = .005), macular hole inner opening (P = .002) and minimum linear diameter (P = .002) were statistically significantly associated with anatomical success. Base diameter (P = .004), macular hole opening (P = .003) and minimum linear diameter (P = .002) were also significantly associated with visual success.
“In the future, an alternative treatment strategy could be planned in those patients with higher base diameter measurements, for example, using a longer-acting gas tamponade or the use of a postoperative posturing regime, in order to improve the chances of anatomical and functional success,” the study authors said.
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