title: Surgery for idiopathic macular holes associated with extensive subretinal fluid.
abstract: OBJECTIVE
  To study the baseline characteristics and outcomes of surgery for idiopathic macular holes associated with localized macular detachment.
  
  
  METHODS
  In this case-control study, eight consecutive patients with idiopathic macular hole associated with localized macular detachment (cases) and 30 randomly selected patients with idiopathic macular hole not associated with macular detachment underwent macular hole surgery.
  
  
  RESULTS
  The mean age (62.1 versus 68.2 years; P = 0.086), mean refractive error (-0.13 versus +0.23 diopters; P = 0.68), average duration of symptoms (5.9 versus 4.6 months; P = 0.47), and macular hole stage (P = 0.43) were similar in the cases and controls. The baseline visual acuity ranged from 20/50-20/80 (1 [13%] versus 1 [3%]) to 20/100-20/200 (2 [25%] versus 24 [80.0%]) to < 20/200 (5 [63%] versus 5 [17%]) (P = 0.10). Single-operation anatomic success was achieved in 2 (25%) cases and 24 (80%) controls (P = 0.007). Visual acuity 3 months after the last macular hole surgery was worse in cases compared to controls: > or = 20/40 in 0 versus 6 (20%), 20/50-20/80 in 1 (13%) versus 13 (43%), 20/100-20/200 in 4 (50%) versus 10 (33%), and < 20/200 in 3 (38%) versus 1 (3%) (P = 0.003). The mean improvement in visual acuity was 0.2 logMAR units in cases versus 0.4 logMAR units in controls (P = 0.054).
  
  
  CONCLUSIONS
  Surgical outcomes for idiopathic macular hole associated with a localized macular detachment compare poorly with the outcomes for macular hole not associated with extensive surrounding subretinal fluid.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33101, USA.
authors.forename: H
authors.initials: H
authors.lastname: Tabandeh
authors.forename: W E
authors.initials: WE
authors.lastname: Smiddy
authors.forename: M
authors.initials: M
authors.lastname: Mello
authors.forename: G
authors.initials: G
authors.lastname: Alexandrakis
authors.forename: H W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Z
authors.initials: Z
authors.lastname: Gregor
authors.forename: J
authors.initials: J
authors.lastname: Schiffman
mesh_terms: D000328:Adult; D000368:Aged; D001826:Body Fluids; D016022:Case-Control Studies; D005122:Exudates and Transudates; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D012163:Retinal Detachment / Q000150:complications; D012167:Retinal Perforations / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C042852:perflutren