Clinical Science

Macular Hole Surgery Prognostic Success Rates Based on Macular Hole Size

Amanda B. Salter, MD; Francisco A. Folgar, MD; Joseph Weissbrot, BA; Kenneth J. Wald, MD

  • Ophthalmic Surgery, Lasers and Imaging
  • May/June 2012 - Volume 43 · Issue 3: 184-189
  • DOI: 10.3928/15428877-20120102-05
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Abstract

BACKGROUND AND OBJECTIVE:

To evaluate the correlation between macular hole (MH) surgery outcomes and preoperative factors believed to affect surgical success rates.

PATIENTS AND METHODS:

A retrospective, consecutive case series was designed to evaluate the correlation between anatomic success and preoperative factors: MH duration prior to surgery, visual acuity (VA), and MH diameter measured by optical coherence tomography (OCT) at the base and the narrowest midpoint.

RESULTS:

A total of 153 eyes were enrolled. There was no significant difference in mean duration prior to surgery for MH success and failure (P = .13). Mean preoperative VA was significantly better for MH success than failure (P = .03). Mean mid-hole diameter (P < .001) and mean base-hole diameter (P < .001) were significantly less for MH success than failure. Failure rate was 0% among eyes with mid-hole diameter less than 500 microns and 14.9% with mid-hole 500 microns or greater (P < .001). Failure rate was 0% among eyes with base-hole diameter less than 500 microns, 1.4% with base-hole 500 to 999 microns, and 19.1% with base-hole of 1,000 microns or greater (P = .001).

CONCLUSION:

Preoperative VA, mid-hole diameter, and base-hole diameter are correlated with anatomic success in MH surgery. An excellent surgical prognosis exists for MHs with mid-hole diameter less than 500 microns and base-hole less than 1,000 microns.

AUTHORS

From the Department of Ophthalmology (ABS, FAF, KJW), New York University Medical Center, New York, New York; Manhattan Eye Ear and Throat Hospital (FAF, KJW), New York, New York; and Brown University (JW), Providence, Rhode Island.

Presented in part at the Association for Research in Vision and Ophthalmology annual meeting, May 2–6, 2010, Fort Lauderdale, Florida.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Amanda B. Salter, MD, 26 Grotto Ave., Apt 1R, Providence, RI 02906. E-mail: amanda.saltermd@gmail.com

Received: April 11, 2011
Accepted: January 06, 2012
Posted Online: February 09, 2012

doi: 10.3928/15428877-20120102-05

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