This study investigates predictors of visual outcomes in patients who underwent vitrectomy for full-thickness macular hole.
Study design
This retrospective, consecutive case series included 132 eyes (122 patients) that underwent pars plana vitrectomy for idiopathic macular hole with at least 1 year of follow-up.
Outcomes
Mean follow-up time was 22.2 months. The mean time to surgery was 21.2 days (range 1–96 days). At final follow-up, poor preoperative vision, perioperative complications and delay from evaluation to surgery were significant predicators of final vision.
Approximately 17% of eyes had AMD, of which 74% were mild and nonexudative. The presence of any form of AMD was a significant predictor of vision at 1 year. Patients with AMD had significantly less improvement in final visual acuity (VA).
Limitations
Inherent limitations exist with this, and any, retrospective, nonrandomized study. Ten different surgeons performed the surgeries, which may introduce variability. Of note, all surgeons peeled the internal limiting membrane during PPV. In addition, the authors were unable to determine the exact cutoff in terms of days to the surgery affecting the final VA decrease.
Clinical significance
Macular hole repair is a frequent surgery for retina specialists, and this study underscores the need for proper preoperative counseling to manage postoperative expectations, especially for patients with AMD.