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Factors predicting normal visual acuity following anatomically successful macular hole surgery

Acta Ophthalmologica Aug 28, 2020

Fallico M, Jackson TL, Chronopoulos A, et al. - Researchers conducted this multicentre, retrospective chart review to evaluate the incidence of normal vision following anatomically successful macular hole surgery and related clinical variables. Preoperative, intraoperative, and postoperative clinical data have been extracted from electronic medical records from seven European vitreoretinal units. Criteria for inclusion were as follows: eyes undergoing primary vitrectomy for idiopathic full‐thickness macular hole from January 2015 to January 2018; postoperative macular hole closure verified by spectral domain optical coherence tomography (OCT); preoperative pseudophakia or phakic eyes receiving combined cataract surgery; one‐year follow‐up. Ninety-one (27.8%) of 327 eligible cases achieved ‘normal vision’ at 1 year. Multivariate analysis identified variables significantly correlated with ‘normal vision’: shorter symptom duration, smaller preoperative OCT minimum linear diameter, and better mean preoperative BCVA. The decision‐tree analysis found that the symptom duration was the most significant variable associated with ‘normal vision.’ Normal vision’ was obtained in 70.6% of eyes operated within one week from symptom onset and in 45% of eyes with symptom duration between 1 and 3 weeks. Such results indicated urgent surgery is justified for small macular holes of short duration.

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