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Visual quality of life after macular hole surgery: outcome and predictive factors
  1. Christoph Hirneiß,
  2. Aljoscha S Neubauer,
  3. Carolin A Gass,
  4. Ingrid W Reiniger,
  5. Siegfried G Priglinger,
  6. Anselm Kampik,
  7. Christos Haritoglou
  1. Dept. of Ophthalmology, Ludwig-Maximilians University, Munich
  1. Correspondence to: Christos Haritogou Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstr. 8, 80336 Munich; christos.haritoglou{at}


Background: In the present study we evaluated the functional success after macular hole surgery in correlation to visual quality of life and looked for predictive factors determining surgical success.

Methods: Fifty-nine patients that underwent pars plana vitrectomy for idiopathic macular hole were included. Follow-up visits were performed in regular intervals after surgery and included a clinical examination, optical coherence tomography (OCT) and measurement of visual acuity. To assess the visual quality of life patients filled out the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) before and three months and one year after surgery.

Results: Macular hole closure was achieved in 57 of 59 patients (97%). Mean visual acuity increased from 20/100 preoperatively to 20/34 one year after surgery (p = 0.02). Despite good visual acuity (20/27) in the fellow eye, visual quality of life (VFQ composite score) rose from 75.9 ± 14.4 (SD) to 81.5 ± 14.2 one year after surgery (p<0.001). Although there was no correlation between the increase in visual quality of life and visual acuity, the increase in VFQ-25 could be well predicted: low visual acuity and significant impairment on VFQ-25 testing preoperatively made patients most likely to benefit from macular hole surgery. A relatively high retinal thickness measurement at the hole border measured on OCT further increases the predictive value.

Conclusion: Macular hole surgery is associated with an increase in visual quality of life despite good visual acuity of the fellow eye. Preoperative visual acuity, VFQ-25 value and partly OCT may help to predict the increase in patients’ vision related quality of life after surgery.

  • HFF, hole form factor
  • ILM, internal limiting membrane
  • OCT, optical coherence tomography
  • VFQ-25, Visual Function Questionnaire

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  • Published Online First 31 October 2006

  • Competing interests: None.