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Outcomes and predictors in macular hole surgery

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 27/09/2013 | 11:00-12:30

Paper Time: 11:24

Venue: Hall 3 (Level 0)

First Author: S.Sinha INDIA

Co Author(s):    P. Kumar   V. Gogia   A. Kumar        

Abstract Details

Purpose:

To evaluate outcomes and various predictors for anatomical success in macular hole surgery

Setting:

Vitreo-Retina department of All India Institute of Medical Sciences, New Delhi.

Methods:

Patients of idiopathic macular hole with stages 2 and above were included and underwent complete ophthalmological evaluation including OCT and standard macular hole surgery. Primary outcome measures included anatomical hole closure and various preoperative factors which could affect surgical outcomes including hole size, duration, size of ILM peel, type of gas tamponade and MHI were studied. Role of these predictors on postoperative external limiting membrane (ELM) status and thus visual outcome was also evaluated.

Results:

Of 62 patients recruited hole closure was achieved in 55 patients (88.7%). Mean age was 64.371 ± 8.758 years. Duration of symptoms, size of macular hole, type of gas tamponade did not affect the anatomical hole closure (p = 0.224, 0.280, 0.403 respectively, chi square test) However, results were better in cases with large ILM peel and were significant. (p=0.05) Mean MHI for eyes with closed hole was 0.4397± 0.1810 and for open hole was 0.3315 ± 0.0968 (p = 0.128) Functional success was achieved in all patients with closed holes. Mean BVCA improved from preoperative 0.9419 ± 0.2615 to 0.4081± 0.2343 (p=0.001). Eyes with continuous ELM achieved better BCVA (> 6/18, on Snellen’s) after macular hole surgery as compared to those eyes which had disrupted ELM.

Conclusions:

Outcomes were acceptable and comparable to other series. Only size of ILM peel was found better predictor of anatomical success. Eyes with continuous ELM postoperatively showed good functional success

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