Outcomes of chronic macular hole surgical repair.

ABSTRACT

Purpose: To report visual and anatomic outcomes of chronic macular hole surgery, with analysis of pre‑operative OCT‑based hole size and post‑operative closure type. Settings and Design: An IRB‑approved, retrospective case series of 26 eyes of 24 patients who underwent surgery for stage 3 or 4 idiopathic chronic macular holes at a tertiary care referral center. Statistical Analysis: Student’s t‑test. Results: Nineteen of 26 eyes (73%) had visual improvement after surgery on most recent exam. Twenty‑one of 26 eyes (81%) achieved anatomic closure; 16 of 26 eyes (62%) achieved type 1, and five of 26 eyes (19%) achieved type 2 closure. Post‑operative LogMAR VA for type 1 closure holes (0.49) was significantly greater than for type 2 closure and open holes (1.26, P < 0.003 and 1.10, P < 0.005, respectively), despite similar pre‑operative VA (P = 0.51 and 0.68, respectively). Mean pre‑operative hole diameter for eyes with type 1 closure, type 2 closure, and holes that remained open were 554, 929, and 1205 microns, respectively. Mean pre‑operative hole diameter was significantly larger in eyes that remained open as compared to eyes with type 1 closure (P = 0.015). Conclusion: Vitrectomy to repair chronic macular holes can improve vision and achieve long‑term closure. Holes of greater than 3.4 years duration were associated with a greater incidence of remaining open and type 2 closure. Larger holes (mean diameter of 1205 microns) were more likely to remain open after repair.