DEC 03, 2009
By Franco Recchia, MD
Retina/Vitreous
Most studies on the outcome of surgery for idiopathic full thickness macular hole surgery have concentrated on rates of anatomical closure. The goal of this retrospective study was to identify factors predicting visual success (better than 20/40; 6/12 Snellen) following macular hole surgery.
It included 133 patients who underwent standardized macular hole surgery and were followed for at least three months. Multivariate regression analysis identified age, preoperative visual acuity and preoperative macular hole size as significant predictors of visual success. The resulting mathematical model based on these three measurements correctly predicted visual outcome in 80 percent of cases.
Predicted range of visual success varied from 2 percent in patients >80 years of age with large holes and a presenting VA of 6/60 or worse and hole diameter of >500 μm, to 93 percent in subjects <60 years of age with a presenting VA of 20/80 or better and a hole of <350 μm.
However, the authors point out that this model may not be applicable with formats of macular hole surgery other than that used exclusively in this study. All patients had combined phaco-vitrectomy, ICG-assisted internal limiting membrane peeling and no prone posturing.
They conclude that, "This novel predictor is easy to use and can provide the patient with guiding information when debating whether to undertake full thickness macular hole surgery. However, the limitations of the predictor must also be taken into account when providing guidance."