The Effect of Retinal Structure on Surgical Success in Macular Holes

Abstract

Purpose: To evaluate the effects of preoperative hole structure and size on postoperative anatomical and functional success in patients with macular holes and determine the changes in retinal layers using optical coherence tomography (OCT). Methods: This study included 48 eyes of 45 patients who underwent surgery with the diagnosis of macular hole between January 1, 2013, and August 1, 2019, and were followed up for at least six months in the postoperative period. Results: Forty-five patients, 23 (51.1%) female and 22 (48.9%) male, were included in the study. There was a statistically significant difference between the preoperative visual acuity and the postoperative third-month and sixth-month visual acuity values. After surgery, visual acuity significantly increased for up to six months. When examining the relationship between hole edge parameters and preoperative visual acuity, a negative correlation was detected between the minimum hole diameter, basal hole diameter and the visual acuities measured at the postoperative. The macular hole index (MHI) and The tractional hole index (THI) had a positive correlation with the postoperative visual acuities. The assessment of the effect of the integrity of the outer limiting membrane (OLM) and the ellipsoid zone (EZ) on postoperative visual acuity at the third and sixth months revealed that visual acuity was higher in patients with OLM and/or EZ integrity at these evaluation times. Conclusion: The surgical closure of macular holes provides anatomical and functional recovery. This study showed that the minimum hole diameter and basal hole diameter, as well as MHI and THI, among the edge parameters measured by preoperative OCT, had a significant effect on functional success.