Long-term Outcome of Idiopathic Macular Hole Surgery
Accepted 5 August 2009. published online 20 October 2009.
Purpose
To evaluate the role of preoperative macular hole (MH) diameter, cataract surgery, and cystoid macular edema (CME) in the reopening of idiopathic macular hole (IMH) after initially successful surgery.
Design
Multicenter, retrospective, comparative case series.
Methods
One hundred and thirty patients (135 eyes) with stage 2, 3, or 4 IMH were included after successful IMH repair at Dijon University Hospital or Nancy University Hospital. The eyes were separated into 4 groups according to the lens status: group 1, vitrectomy in pseudophakic eyes; group 2, vitrectomy and cataract extraction as a combined procedure; group 3, vitrectomy followed by cataract extraction; group 4, vitrectomy on eyes that remained phakic. All patients underwent a complete vitrectomy with retinal inner limiting membrane peeling and intraocular gas tamponade. The main outcome measures were IMH closure rate and best-corrected visual acuity.
Results
Mean duration of symptoms was 8.6 ± 7.6 months. The follow-up was 37 ± 8.6 months (range, 30 to 67 months). The mean preoperative IMH diameter was 454 ± 191 μm. No MH reopened during the follow-up after the initial vitreous surgery. Seven cases of CME were observed (1 in groups 1 and 2; 5 in group 3), and cataract surgery was performed in the 53 patients in group 3 with a mean delay of 11.6 months.
Conclusions
Cataract extraction, CME, or preoperative MH diameter measured by optical coherence tomography were not identified as risk factors for IMH reopening.
aDepartment of Ophthalmology, University Hospital, Dijon, France
bDepartment of Ophthalmology, University Hospital, Nancy, France
Inquiries to Catherine Creuzot-Garcher, Service d'Ophtalmologie, CHU Dijon, Rue du Faubourg Raines, 21000 Dijon, France
ABSTRACT