title: Functional and morphologic outcomes after reoperation for persistent idiopathic macular hole.
abstract: OBJECTIVE
  To determine the relationship between preoperative and postoperative characteristics and visual outcomes after successful surgery for unclosed macular hole (MH).
  
  
  METHODS
  The medical charts of 166 eyes of 161 patients who underwent vitrectomy for a MH were reviewed. The MH was not closed in 9 eyes of 9 patients after the initial surgery. The second vitrectomy with additional internal limiting membrane (ILM) peeling and gas tamponade was performed. The preoperative and postoperative best-corrected visual acuity (BCVA), optical coherence tomographic images, MH size, duration of MH before the first operation, and area of ILM peeling were studied.
  
  
  RESULTS
  The MH was closed in all eyes after the second surgery. The BCVA significantly improved from 0.77 to 0.25 logMAR units (20/118 to 20/36, p = 0.002). The postoperative subfoveal ellipsoid zone (EZ) was distinct and continuous in 3 eyes with good visual recovery. The final BCVA was not significantly correlated with the baseline characteristics and area of ILM peeling but was correlated with the postoperative status of the EZ.
  
  
  CONCLUSIONS
  All MHs were closed and the mean postoperative visual acuity was significantly improved. The reason for poor visual recovery was the reduced microstructural recovery after the second surgery.
authors.affiliation: Department of Ophthalmology, Teikyo University Chiba Medical Center, Chiba - Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hagiwara
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Baba
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tatsumi
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan.
authors.forename: Eiju
authors.initials: E
authors.lastname: Sato
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oshitari
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012160:Retina / Q000503:physiopathology; D012167:Retinal Perforations / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*