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

  • Retinal Disorders
  • Published:
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Abstract

Objective

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.

Methods

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).

Results

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 (p≥0.18). Postoperative BCVA was significantly better in group C compared to groups A and B (p ≤ 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).

Conclusions

Outer retina restoration seems to be the best determining factor for a good visual rehabilitation after MH surgery.

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Conflict of interest

The authors have no financial or proprietary interest in a product, method, or material described herein.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain

    José Maria Ruiz-Moreno

  2. Alicante Institute of Ophthalmology, VISSUM, Vitreo-Retinal Unit, Alicante, Spain

    José Maria Ruiz-Moreno, Francisco Lugo & Javier A. Montero

  3. Pío del Rio Hortega University Hospital, Valladolid, Spain

    Javier A. Montero

  4. Department of Optics, Pharmacology and Anatomy, Alicante University, Alicante, Spain

    David P. Piñero

  5. Facultad de Medicina, Departamento de Ciencias Médicas, Avda. de Almansa, 14, 02006, Albacete, Spain

    José Maria Ruiz-Moreno

Authors
  1. José Maria Ruiz-Moreno
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  2. Francisco Lugo
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  3. Javier A. Montero
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  4. David P. Piñero
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Corresponding author

Correspondence to José Maria Ruiz-Moreno.

Additional information

This study was supported in part by a grant from the Spanish Ministry of Health, Instituto de Salud Carlos III, Red Temática de Investigación Cooperativa en Salud "Patología ocular del envejecimiento, calidad visual y calidad de vida" (RD07/0062/0019).

All the authors have full control of all primary data and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review the data of the current study if requested. Section: Retina

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Ruiz-Moreno, J.M., Lugo, F., Montero, J.A. et al. Restoration of macular structure as the determining factor for macular hole surgery outcome. Graefes Arch Clin Exp Ophthalmol 250, 1409–1414 (2012). https://doi.org/10.1007/s00417-012-1963-2

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  • DOI: https://doi.org/10.1007/s00417-012-1963-2

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