Restoration of macular structure as the determining factor for macular hole surgery outcome

The aim of this work is to evaluate the preoperative and postoperative spectral domain optical coherence tomography (SD-OCT) findings as predictors of visual acuity for macular hole (MH) surgery. Fifty eyes of 46 patients diagnosed with MH and that had undergone 25-g vitrectomy with internal limiting membrane peeling were included in this retrospective study. A complete clinical examination and SD-OCT were performed before and after surgery. Three groups were considered on the basis of the postoperative integrity of photoreceptor inner and outer segment (IS-OS) junction and the external limiting membrane (ELM): group A (11 eyes, both lines disrupted), group B (ten eyes, disrupted IS/OS line and complete ELM), and group C (29 eyes, both lines restored). LogMAR BCVA improved significantly after surgery from an average 0.60 +/- 0.29 to 0.19 +/- 0.19 (p < 0.01). No significant differences had been detected preoperatively among these groups (pa parts per thousand yen0.18). Postoperative BCVA was significantly better in group C compared to groups A and B (p a parts per thousand currency signaEuro parts per thousand 0.01). A significant correlation was found between ELM restoration and postoperative BCVA (r = -0.63, p < 0.01), as well as between IS/OS line restoration and postoperative BCVA (r = -0.55, p < 0.01). Outer retina restoration seems to be the best determining factor for a good visual rehabilitation after MH surgery.