Surgery for idiopathic full-thickness macular holes within four months of symptom onset yields superior visual outcomes: Results from an Irish patient cohort.

التفاصيل البيبلوغرافية
العنوان:	Surgery for idiopathic full-thickness macular holes within four months of symptom onset yields superior visual outcomes: Results from an Irish patient cohort.
المؤلفون:	McCabe GA; Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland. gracemccabe000@gmail.com., Zaidi SBH; Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland., O'Riordan MM; Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland., Kennelly KP; Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland.
المصدر:	Irish journal of medical science [Ir J Med Sci] 2024 Jun; Vol. 193 (3), pp. 1665-1670. Date of Electronic Publication: 2023 Dec 19.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Royal Academy of Medicine of Ireland Country of Publication: Ireland NLM ID: 7806864 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1863-4362 (Electronic) Linking ISSN: 00211265 NLM ISO Abbreviation: Ir J Med Sci Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Dublin : Royal Academy of Medicine of Ireland
مواضيع طبية MeSH:	Retinal Perforations/surgery , Retinal Perforations/physiopathology , Visual Acuity*, Humans ; Female ; Aged ; Male ; Middle Aged ; Retrospective Studies ; Aged, 80 and over ; Treatment Outcome ; Vitrectomy/methods ; Ireland ; Time Factors
مستخلص:	Purpose: To describe the anatomical, visual, and safety results of full-thickness macular hole (FTMH) repair surgery and determine factors influencing outcomes. Patients and Methods: A retrospective chart review was performed on all patients who underwent primary FTMH repair surgery by a single surgeon over a 3-year period. For comparisons, Snellen visual acuity (VA) was converted to logMAR equivalent. Anatomical hole closure, visual improvement, and final VA of ≤ 0.30 logMAR were the primary outcome measures. Results: Twenty eyes of 19 patients were included. Mean patient age was 69 years (range 55 to 80 years) and 74% were female. Mean minimum linear diameter (MLD) was 440 μm (range 170 μm to 1200 μm). Mean duration of symptoms before surgery was 16 weeks (range 3 to 39 weeks). 100% of eyes achieved successful anatomical FTMH closure. Mean VA improved from 1.03 ± 0.43 logMAR (Snellen 6/60) preoperatively to 0.35 ± 0.22 logMAR (Snellen 6/15) postoperatively (p = 0.0001). Patients with worse preoperative VA gained more vision than those with better preoperative VA (p = 0.01). Eyes operated on within 4 months of symptom onset were more than twice as likely to achieve a postoperative VA of ≤ 0.30 logMAR (Snellen 6/12 or better) compared to eyes with a longer duration of symptoms (p = 0.03). Conclusion: FTMH repair surgery was safe and effective, with outcomes comparing favourably with published international studies. All patients benefited from surgery regardless of symptom duration, presenting VA or FTMH size. However, surgery performed within 4 months of symptom-onset was particularly beneficial, highlighting the need for prompt referral and surgery. (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)
References:	Meuer SM, Myers CE, Klein BEK et al (2015) The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the beaver dam eye study. Ophthalmology 122(4):787–795. https://doi.org/10.1016/j.ophtha.2014.10.014. (PMID: 10.1016/j.ophtha.2014.10.01425556116) Mitchell P, Smith W, Chey T et al (1997) Prevalence and associations of epiretinal membranes. Ophthalmology 104(6):1033–1040. https://doi.org/10.1016/s0161-6420(97)30190-0. (PMID: 10.1016/s0161-6420(97)30190-09186446) Wang S, Xu L, Jonas JB (2006) Prevalence of full-thickness macular holes in urban and rural adult Chinese: the Beijing eye study. Am J Ophthalmol 141(3):589–591. https://doi.org/10.1016/j.ajo.2005.10.021. (PMID: 10.1016/j.ajo.2005.10.02116490523) Sen P, Bhargava A, Vijaya L, George R (2008) Prevalence of idiopathic macular hole in adult rural and urban south Indian population. Clin Exp Ophthalmol 36(3):257–260. https://doi.org/10.1111/j.1442-9071.2008.01715.x. McCannel CA, Ensminger JL, Diehl NN et al (2009) Population based incidence of macular holes. Ophthalmology 116(7):1366. https://doi.org/10.1016/j.ophtha.2009.01.052. (PMID: 10.1016/j.ophtha.2009.01.05219576500) Johnson RN, Gass JDM (1988) Idiopathic macular holes. Observations, stages of formation, and implications for surgical intervention. Ophthalmology 95(7):917–924. https://doi.org/10.1016/s0161-6420(88)33075-7. Duker JS, Kaiser PK, Binder S et al (2013) The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120(12):2611–2619. https://doi.org/10.1016/j.ophtha.2013.07.042. (PMID: 10.1016/j.ophtha.2013.07.04224053995) Kelly NE, Wendel RT (1991) Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol 109(5):654–659. https://doi.org/10.1001/archopht.1991.01080050068031. Jackson TL, Donachie PHJ, Sparrow JM et al (2013) United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 2, macular hole. Ophthalmology 120(3):629–634. https://doi.org/10.1016/j.ophtha.2012.09.003. (PMID: 10.1016/j.ophtha.2012.09.00323211634) Essex RW, Hunyor AP, Moreno-Betancur M et al (2018) The visual outcomes of macular hole surgery: A registry-based study by the Australian and New Zealand Society of retinal specialists. Ophthalmol Retina 2(11):1143–1151. https://doi.org/10.1016/j.oret.2018.04.022. (PMID: 10.1016/j.oret.2018.04.02231047553) Kim JW, Freeman WR, Azen SP et al (1996) Prospective randomized trial of vitrectomy or observation for stage 2 macular holes. Vitrectomy for macular hole study group. Am J Ophthalmol 121(6):605–614. https://doi.org/10.1016/s0002-9394(14)70625-7. Salter AB, Folgar FA, Weissbrot J et al (2012) Macular hole surgery prognostic success rates based on macular hole size. Ophthalmic Surg Lasers Imaging 43(3):184–189. https://doi.org/10.3928/15428877-20120102-05. (PMID: 10.3928/15428877-20120102-0522320413) Gupta B, Laidlaw DAH, Williamson TH et al (2009) Predicting visual success in macular hole surgery. Br J Ophthalmol 93(11):1488–1491. https://doi.org/10.1136/bjo.2008.153189. (PMID: 10.1136/bjo.2008.15318919635721) Mester V, Kuhn F (2000) Internal limiting membrane removal in the management of full-thickness macular holes. Am J Ophthalmol 129(6):769–777. https://doi.org/10.1016/s0002-9394(00)00358-5. (PMID: 10.1016/s0002-9394(00)00358-510926987) Vaziri K, Schwartz SG, Kishor KS et al (2016) Rates of reoperation and retinal detachment after macular hole surgery. Ophthalmology 123(1):26–31. https://doi.org/10.1016/j.ophtha.2015.09.015. (PMID: 10.1016/j.ophtha.2015.09.01526505804) Steel DH, Donachie PHJ, Aylward GW et al (2021) Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort. Eye 35(1):316–325. https://doi.org/10.1038/s41433-020-0844-x. (PMID: 10.1038/s41433-020-0844-x32231259) Lange C, Feltgen N, Junker B et al (2009) Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT). Graefes Arch Clin Exp Ophthalmol 247(1):137–142. https://doi.org/10.1007/s00417-008-0926-0. (PMID: 10.1007/s00417-008-0926-018766368) Steel DHW, Downey L, Greiner K et al (2016) The design and validation of an optical coherence tomography-based classification system for focal vitreomacular traction. Eye (Lond) 30(2):314–324. https://doi.org/10.1038/eye.2015.262. (PMID: 10.1038/eye.2015.26226768921) Tognetto D, Grandin R, Sanguinetti G et al (2006) Internal limiting membrane removal during macular hole surgery: results of a multicenter retrospective study. Ophthalmology 113(8):1401–1410. https://doi.org/10.1016/j.ophtha.2006.02.061. (PMID: 10.1016/j.ophtha.2006.02.06116877079) Steel DHW (2007) Phacovitrectomy: expanding indications. J Cataract Refract Surg 33(6):933–936. https://doi.org/10.1016/j.jcrs.2007.01.047. (PMID: 10.1016/j.jcrs.2007.01.04717531668) Simcock PR, Scalia S (2001) Phacovitrectomy without prone posture for full thickness macular holes. Br J Ophthalmol 85(11):1316. https://doi.org/10.1136/bjo.85.11.1316. (PMID: 10.1136/bjo.85.11.1316116732971723751) Elhusseiny AM, Soliman MK, Shakarchi AF et al (2023) Visual outcomes and complications of combined vs sequential cataract surgery and pars plana vitrectomy: multicenter database study. J Cataract Refract Surg 49(2):142–147. https://doi.org/10.1097/j.jcrs.0000000000001059. (PMID: 10.1097/j.jcrs.000000000000105936100160)
فهرسة مساهمة:	Keywords: Full-thickness macular hole; Vitrectomy; Vitreomacular; Vitreoretinal
تواريخ الأحداث:	Date Created: 20231220 Date Completed: 20240526 Latest Revision: 20240526
رمز التحديث:	20240527
DOI:	10.1007/s11845-023-03592-3
PMID:	38114866
قاعدة البيانات:	MEDLINE

Find this article in full text from Springer Verlag.

Full Text Finder

الوصف
تدمد:	1863-4362
DOI:	10.1007/s11845-023-03592-3