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Persistent Subretinal Fluid After Successful Full-Thickness Macular Hole Surgery: Prognostic Factors, Morphological Features and Implications on Functional Recovery

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Abstract

Introduction

The present study aimed to identify preoperative factors that predispose the development of subretinal fluid (SRF) following successful macular hole (MH) surgery.

Methods

Thirty-four eyes of 33 consecutive patients that underwent pars plana vitrectomy for idiopathic full-thickness MH surgery were included in this retrospective study. Best corrected visual acuity (BCVA), and spectral domain-optical coherence tomography (OCT) images were evaluated pre- and postoperatively in all cases. Patient’s demographic characteristics, stage of MH, measurements of base diameter and minimum aperture diameter of the MH, preoperative foveal vitreomacular traction and selected intra-operative parameters were correlated with the development of postoperative SRF.

Results

Postoperative SRF was observed in 15 cases (48%). Total absorption of SRF was observed in 73% of affected eyes and was most commonly seen between the third and the fifth postoperative month. One patient developed lamellar hole leading to full-thickness MH. Postoperative BCVA was similar between the eyes that did and the eyes that did not develop postoperative SRF (0.31 ± 0.2 vs 0.35 ± 0.2; p ≥ 0.05). Development of postoperative SRF was significantly associated with the presence of preoperative foveal vitreomacular traction (p = 0.048), stage II MH (p = 0.017) and smaller size of the closest distance between the MH edges (p = 0.046).

Conclusions

Postoperative SRF is a common occurrence following successful MH surgery. Meticulous evaluation of preoperative clinical and OCT findings may disclose risk factors associated with this condition. Based on our observations, idiopathic holes of early stage appear to be at a higher risk of developing postoperative SRF. This could be a point of interest with the advancing use of enzymatic proteolysis.

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Acknowledgments

No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.

Conflict of interest

P.G. Tranos, P. Stavrakas, A.N. Vakalis, S. Asteriadis, E. Lokovitis and A.G.P. Konstas have no disclosures to declare.

Compliance with ethics guidelines

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Ophthalmica Eye Institute, Thessaloniki, Greece

    Paris G. Tranos, Athanasios N. Vakalis, Solon Asteriadis, Evangelos Lokovitis & Anastasios G. P. Konstas

  2. 2nd Department of Ophthalmology, University of Athens Medical School, Athens, Greece

    Panagiotis Stavrakas

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  1. Paris G. Tranos
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  2. Panagiotis Stavrakas
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  3. Athanasios N. Vakalis
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  4. Solon Asteriadis
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  5. Evangelos Lokovitis
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  6. Anastasios G. P. Konstas
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Correspondence to Anastasios G. P. Konstas.

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Tranos, P.G., Stavrakas, P., Vakalis, A.N. et al. Persistent Subretinal Fluid After Successful Full-Thickness Macular Hole Surgery: Prognostic Factors, Morphological Features and Implications on Functional Recovery. Adv Ther 32, 705–714 (2015). https://doi.org/10.1007/s12325-015-0227-z

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  • DOI: https://doi.org/10.1007/s12325-015-0227-z

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