title: Visual function and subjective perception of visual ability after macular hole surgery.
abstract: OBJECTIVE
  To evaluate the functional and anatomical results of macular hole surgery and to explore its effect on patients' Health-Related Quality Of Life (HR-QOL) and to investigate the associations between self-reported HR-QOL and conventional measures of visual function.
  
  
  METHODS
  Case series.
  
  
  METHODS
  The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and the 36-Item Short-Form Health Survey (SF-36) were self-administered by 30 patients before and 4 months after macular hole surgery. Preoperative, intraoperative, and postoperative clinical data were collected including visual acuity, contrast sensitivity, and metamorphopsia. Multi-item scales rating different aspects of HR-QOL were compared before and after surgery, and their correlation with traditional methods of outcome evaluation was analyzed.
  
  
  RESULTS
  Macular hole closure was achieved in 26 patients (87%). Mean LogMAR visual acuity improved by 6 +/- 10 letters for distance and 7 +/- 12 letters for near. Metamorphopsia was reduced by a mean of 35 +/- 70 squares on Amsler chart, and Pelli-Robson contrast sensitivity decreased by a mean of -0.09 +/- 0.3 log units postoperatively. The VFQ-25 composite score as well as scale scores associated with general vision, near vision, vision-related mental health, and role difficulties were significantly improved (P < .05) after successful closure of macular hole. Conversely out of the eight SF-36 health concepts, limitation in usual role activities because of emotional problems was the only one that significantly improved postoperatively. Both baseline and postoperative best-corrected visual acuity significantly correlated with most of the VFQ subscale scores before and after surgery, respectively.
  
  
  CONCLUSIONS
  In this case-series, macular hole surgery appears to have a beneficial effect on patients' subjective perception of visual function. The use of vision-targeted health status questionnaires in conjunction with detailed clinical examination provides a more comprehensive overview of individuals' daily well-being after surgical intervention. Further controlled studies are required to confirm our findings.
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom. ptranos@doctors.org.uk
authors.forename: Paris G
authors.initials: PG
authors.lastname: Tranos
authors.forename: Seyed M S
authors.initials: SM
authors.lastname: Ghazi-Nouri
authors.forename: Gary S
authors.initials: GS
authors.lastname: Rubin
authors.forename: Zoe C
authors.initials: ZC
authors.lastname: Adams
authors.forename: David G
authors.initials: DG
authors.lastname: Charteris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*