Surgical Results of Vitrectomy for Longstanding Idiopathic Macular Hole: Factors Affecting Postoperative Prognosis

ABSTRACT

Results of vitrectomy as treatment of full thickness(stage 3,4) macular hole were reported large variability and difference n anatomical and funtional success rate. So many surgeons fely difficulty in expectation of postoperative results before operation on stage 3,4. To use decision of proper operation time & effective treatment and expect the postoperative results before operation, after anatomical & functional factor affecting postoperative results & prognosis were arranged, relationship of these data after vitrectomy were evaluated. Pars plana vitrectomy in 25 patients(25 eyes) with stage 3(8 eyes) and stage 4(17 eyes) macular hole was performed. Functional success was seen in 7 eye(28%) and Anatomical success was seen in 12 eyes(48%). Preoperative factors such an stage of macular hole, preoperative visual acuity, size or macular hole, and sex were not found any association with postoperative functional & anatomical success rate. the group that had completely attached hole after vitrectomy and small preoperative cuff size(<1.0mm) were showed improvement of visual acuity compared with the other group. But these results were statistically not significant. And patients (5 eyes) with additional removal of ILM with PVD or memb peeling were showed good anatomical success rate(80%), but no difference of postoperative visual acuity compared with the other group. Although preoperative fluid cuff size and around hole and completely closure of hole after surgery were statistically not significant, highly correlated with postoperative visual acuity compared with the other factor. But long-term follow-up & recruitment of additional cases are required to consider as one of the significant factor on deciding operation time & expecting postoperative result.