title: Visual quality of life after macular hole surgery: outcome and predictive factors.
abstract: BACKGROUND
  In the present study we evaluated the functional success after macular hole surgery in correlation to visual quality of life and looked for predictive factors determining surgical success.
  
  
  METHODS
  Fifty-nine patients that underwent pars plana vitrectomy for idiopathic macular hole were included. Follow-up visits were performed in regular intervals after surgery and included a clinical examination, optical coherence tomography (OCT) and measurement of visual acuity. To assess the visual quality of life patients filled out the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) before and three months and one year after surgery.
  
  
  RESULTS
  Macular hole closure was achieved in 57 of 59 patients (97%). Mean visual acuity increased from 20/100 preoperatively to 20/34 one year after surgery (p = 0.02). Despite good visual acuity (20/27) in the fellow eye, visual quality of life (VFQ composite score) rose from 75.9 +/- 14.4 (SD) to 81.5 +/- 14.2 one year after surgery (p<0.001). Although there was no correlation between the increase in visual quality of life and visual acuity, the increase in VFQ-25 could be well predicted: low visual acuity and significant impairment on VFQ-25 testing preoperatively made patients most likely to benefit from macular hole surgery. A relatively high retinal thickness measurement at the hole border measured on OCT further increases the predictive value.
  
  
  CONCLUSIONS
  Macular hole surgery is associated with an increase in visual quality of life despite good visual acuity of the fellow eye. Preoperative visual acuity, VFQ-25 value and partly OCT may help to predict the increase in patients' vision related quality of life after surgery.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstr. 8, 80336 Munich.
authors.forename: Christoph
authors.initials: C
authors.lastname: Hirneiss
authors.forename: Aljoscha S
authors.initials: AS
authors.lastname: Neubauer
authors.forename: Carolin A
authors.initials: CA
authors.lastname: Gass
authors.forename: Ingrid W
authors.initials: IW
authors.lastname: Reiniger
authors.forename: Siegfried G
authors.initials: SG
authors.lastname: Priglinger
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012167:Retinal Perforations / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000534:rehabilitation; D014792:Visual Acuity; D014821:Vitrectomy