Publication
Predictive Factors of the Anatomical and Functional Success of Macular Hole Surgery
| Summary: | Introduction: Idiopathic macular hole (iMH) is a vitreoretinal interface pathology which is treatment is surgical-based. Currently, the anatomical success rate of the surgery varies between 85% and 100%, however, the functional recovery of visual acuity may be limited despite successfully closing the iMH. Our purpose was to identify preoperative factors that better predict the anatomical and functional success of iMH surgery. Methods: Retrospective cohort study of patients submitted to pars plana vitrectomy for iMH treatment aided by peeling of the internal limiting membrane or inverted flap technique, between January 2015 and December 2019, at Hospital de Braga. The following parameters were evaluated: age, sex, best preoperative corrected visual acuity (preBCVA), time spent from diagno- sis to surgery (TTS), iMH size, presence of concomitant epiretinal membrane or adherent posterior hyaloid membrane (PHM) and surgical technique used. The correlation between the described parameters and the anatomical surgical success and the postoperative BCVA (functional success) was evaluated. Results: Seventy-one eyes of 67 patients were included, with female predominance (71.6%) and a mean age of 68.3 ± 8.3 years at diagnosis. Anatomical success was obtained in 70.4% eyes and none of the factors analyzed had a statistically significant impact on the anatomical success of the surgery. On the other hand, it was observed that preBCVA (b = 0.540; t = 5.371; p <0.001), TTS (b = 0.001; t = 2.203; p = 0.031) and adherent PHM (b = -0.258; t = -2.098; p = 0.043) had a significant impact on postoperative BCVA. Multivariate linear regression analysis showed that only preBCVA had an impact in predicting functional recovery (b = 0.381; t = 2.784; p = 0.009). Conclusion: Preoperative visual acuity is the best predictor of the functional success of iMH surgery, suggesting that it allows a better management of patient ́s pre-surgical expectations. |
|---|---|
| Main Authors: | Neves Cruz, Carlos |
| Other Authors: | Pinto, Christophe; Figueiredo, Ana; Mendonça, Luis; Calvão-Santos, Gil; Sousa, Keissy |
| Subject: | Artigos Originais |
| Year: | 2023 |
| Country: | Portugal |
| Document type: | article |
| Access type: | open access |
| Associated institution: | Sociedade Portuguesa de Oftalmologia |
| Language: | English |
| Origin: | Revista Sociedade Portuguesa de Oftalmologia |
| Summary: | Introduction: Idiopathic macular hole (iMH) is a vitreoretinal interface pathology which is treatment is surgical-based. Currently, the anatomical success rate of the surgery varies between 85% and 100%, however, the functional recovery of visual acuity may be limited despite successfully closing the iMH. Our purpose was to identify preoperative factors that better predict the anatomical and functional success of iMH surgery. Methods: Retrospective cohort study of patients submitted to pars plana vitrectomy for iMH treatment aided by peeling of the internal limiting membrane or inverted flap technique, between January 2015 and December 2019, at Hospital de Braga. The following parameters were evaluated: age, sex, best preoperative corrected visual acuity (preBCVA), time spent from diagno- sis to surgery (TTS), iMH size, presence of concomitant epiretinal membrane or adherent posterior hyaloid membrane (PHM) and surgical technique used. The correlation between the described parameters and the anatomical surgical success and the postoperative BCVA (functional success) was evaluated. Results: Seventy-one eyes of 67 patients were included, with female predominance (71.6%) and a mean age of 68.3 ± 8.3 years at diagnosis. Anatomical success was obtained in 70.4% eyes and none of the factors analyzed had a statistically significant impact on the anatomical success of the surgery. On the other hand, it was observed that preBCVA (b = 0.540; t = 5.371; p <0.001), TTS (b = 0.001; t = 2.203; p = 0.031) and adherent PHM (b = -0.258; t = -2.098; p = 0.043) had a significant impact on postoperative BCVA. Multivariate linear regression analysis showed that only preBCVA had an impact in predicting functional recovery (b = 0.381; t = 2.784; p = 0.009). Conclusion: Preoperative visual acuity is the best predictor of the functional success of iMH surgery, suggesting that it allows a better management of patient ́s pre-surgical expectations. |
|---|