Long-term outcome of idiopathic macular hole surgery.
OBJECTIVE
To evaluate the role of preoperative macular hole (MH) diameter, cataract surgery, and cystoid macular edema (CME) in the reopening of idiopathic macular hole (IMH) after initially successful surgery.


METHODS
Multicenter, retrospective, comparative case series.


METHODS
One hundred and thirty patients (135 eyes) with stage 2, 3, or 4 IMH were included after successful IMH repair at Dijon University Hospital or Nancy University Hospital. The eyes were separated into 4 groups according to the lens status: group 1, vitrectomy in pseudophakic eyes; group 2, vitrectomy and cataract extraction as a combined procedure; group 3, vitrectomy followed by cataract extraction; group 4, vitrectomy on eyes that remained phakic. All patients underwent a complete vitrectomy with retinal inner limiting membrane peeling and intraocular gas tamponade. The main outcome measures were IMH closure rate and best-corrected visual acuity.


RESULTS
Mean duration of symptoms was 8.6 +/- 7.6 months. The follow-up was 37 +/- 8.6 months (range, 30 to 67 months). The mean preoperative IMH diameter was 454 +/- 191 mum. No MH reopened during the follow-up after the initial vitreous surgery. Seven cases of CME were observed (1 in groups 1 and 2; 5 in group 3), and cataract surgery was performed in the 53 patients in group 3 with a mean delay of 11.6 months.


CONCLUSIONS
Cataract extraction, CME, or preoperative MH diameter measured by optical coherence tomography were not identified as risk factors for IMH reopening.
Department of Ophthalmology, University Hospital, Dijon, France.
Marie
M
Passemard
Younes
Y
Yakoubi
Aurore
A
Muselier
Isabelle
I
Hubert
Alexandre
A
Guillaubey
Alain M
AM
Bron
Jean Paul
JP
Berrod
Catherine
C
Creuzot-Garcher
D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012008:Recurrence; D012167:Retinal Perforations / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride