title: Restoration of macular structure as the determining factor for macular hole surgery outcome.
abstract: OBJECTIVE
  The aim of this work is to evaluate the preoperative and postoperative spectral domain optical coherence tomography (SD-OCT) findings as predictors of visual acuity for macular hole (MH) surgery.
  
  
  METHODS
  Fifty eyes of 46 patients diagnosed with MH and that had undergone 25-g vitrectomy with internal limiting membrane peeling were included in this retrospective study. A complete clinical examination and SD-OCT were performed before and after surgery. Three groups were considered on the basis of the postoperative integrity of photoreceptor inner and outer segment (IS-OS) junction and the external limiting membrane (ELM): group A (11 eyes, both lines disrupted), group B (ten eyes, disrupted IS/OS line and complete ELM), and group C (29 eyes, both lines restored).
  
  
  RESULTS
  LogMAR BCVA improved significantly after surgery from an average 0.60 ± 0.29 to 0.19 ± 0.19 (p < 0.01). No significant differences had been detected preoperatively among these groups (p≥0.18). Postoperative BCVA was significantly better in group C compared to groups A and B (p ≤ 0.01). A significant correlation was found between ELM restoration and postoperative BCVA (r = -0.63, p < 0.01), as well as between IS/OS line restoration and postoperative BCVA (r = -0.55, p < 0.01).
  
  
  CONCLUSIONS
  Outer retina restoration seems to be the best determining factor for a good visual rehabilitation after MH surgery.
authors.affiliation: Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain. josemaria.ruiz@uclm.es
authors.forename: José Maria
authors.initials: JM
authors.lastname: Ruiz-Moreno
authors.forename: Francisco
authors.initials: F
authors.lastname: Lugo
authors.forename: Javier A
authors.initials: JA
authors.lastname: Montero
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D012372:ROC Curve; D012167:Retinal Perforations / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy