[Functional results after anatomically successful surgery for stage III/IV macular hole].
OBJECTIVE
To report the functional results after anatomically successful surgery for stage III/IV macular hole.


METHODS
Follow-up examinations (ETDRS charts, Birkhäuser near visual acuity charts, OCT) were carried out in 29 patients 11+/-5 months after surgery for stage III/IV macular hole (hole size >400 microm); in all cases the foveal contour had been restored postoperatively . The surgery performed also included cataract surgery (n=26), vitrectomy, ICG-assisted ILM peeling (in which perfluorcarbon liquid was used to prevent ICG from coming in contact with the retinal pigment epithelium) and tamponade with intraocular gas (n=16) or silicone oil (n=13). Silicone oil had been removed by the time of the follow-up evaluation.


RESULTS
Preoperative mean BCVA was 0.2 (0.64 logMAR+/-0.24) and postoperative BCVA, 0.5 (0.3 logMAR+/-0.19). None of the patients experienced any deterioration in sight; the average improvement in visual acuity was 3.5+/-2 lines. In 70% (n=20) of the patients the postoperative BCVA was > or =0.5. Visual acuity for near sight was 0.45+/-0.2. In 66% (n=19) a visual acuity of > or =0.4 was achieved for close work. The improvement in visual acuity was not related to the kind of endotamponade or to the size of the macular hole. Patients with macular hole diameters of 400-800 microm (n=20) gained 3.5+/-2.,4 lines, while in patients with macular hole diameters of 800-1135 microm the average gain was 3.6+/-1.3 lines.


CONCLUSIONS
Anatomically successful macular hole stage III/IV surgery with ICG-assisted ILM peeling and protection of the retinal pigment epithelium from contact with ICG by perfluorcarbon liquid can yield good functional results.
Wrede
J
J
Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Stefan.Dithmar@med.uni-heidelberg.de
Engler
C
C
Dithmar
S
S
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D003131:Combined Modality Therapy; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010786:Photoreceptor Cells / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D012167:Retinal Perforations / Q000145:classification / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy