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Predicting visual success in macular hole surgery
  1. Bhaskar Gupta1,
  2. David A Laidlaw1,
  3. Shaheen Shah2,
  4. Roger Wong1 and
  5. Siobhan Wren1
  1. 1 St. Thomas' Hospital, United Kingdom;
  2. 2 London School of Hygiene and Tropical Medicine, United Kingdom
  1. * Corresponding author; email: alistair.laidlaw{at}gstt.nhs.uk

Abstract

Introduction: Surgical outcome data facilitate informed pre operative patient counseling. Most studies to date on the outcome of surgery for idiopathic full thickness macular hole (IFTMH) surgery have tended to concentrate on rates of anatomical closure. The aim of this study was to investigate for factors predicting visual success (better than 20/40; 6/12 Snellen) following macular hole surgery.

Methods: A retrospective study of 133 patients undergoing standardised macular hole surgery with at least 3 months of post operative follow up. All patients underwent pre operative measurement of the maximum macular hole diameter using optical coherence tomography.

Results: Multivariable regression analysis identified that age, pre operative visual acuity and macular hole size were significant predictors of visual success. The resulting model correctly classified the visual outcome of 80% of cases. Predicted rates of visual success varied from 93% in patients <60 years with acuity better than 20/80(6/24) and a hole diameter of <350 microns to 2% in patients those >79 years with acuity of 20/200(6/60) or worse and hole diameter of >500 microns.

Conclusion: The results provide a simple and clinically useful model to employ when counseling patients regarding macular hole surgery.

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