Risk factors for visual acuity after idiopathic macular hole surgery

Abstract

Abstract Background To investigate the postoperative visual acuity of idiopathic macular hole (IMH) with 23G vitrectomy and its associated factors.Methods 71 patients (75 eyes) were included in this retrospective study, we assessed the different risk factors that might be associated with visual acuity after IMH surgery which were treated in our department between April 2015 and July 2021. The patients comprised 16 males (16 eyes) and 55 females (59 eyes) with mean age 61.9 ± 9.0 years. Data on sex, age, eyes, macular hole (MH) duration, visual acuity (VA), minimum linear diameter (MLD), base diameter (BD), external limiting embrane (ELM), ellipsoid zone (EZ), axial length (AL), surgical methods, tamponade, nerve growth factor (NGF) and posterior vitreous detachment (PVD) were collected. Logistics regression analysis of risk factors associated with visual acuity after IMH surgery.Results Univariate logistic regression analysis revealed that preoperative VA and MH duration were significant risk factors for VA after IMH surgery (all p < 0.05). The overall closure rate was 100%. There was statistically significant difference in the VA between preoperation and postoperation using paired t-test (p = 0.000). The mean best corrected VA increased from 0.99 ± 0.38 logMAR before surgery to 0.64 ± 0.32 logMAR. Moreover, the VA after surgery of the coverage group was greater than the insertion group. The postoperation VA of MH duration ≤ 3 months group was better than the VA of MH duration > 6 months (p = 0.003).Conclusions Ophthalmologists should be aware of the preoperatice VA and MH duration are the risk factors of VA after IMH surgery. Early surgery is necessary for IMH according to surgical indication. Poor VA and the long MH duration before surgery will influence the IMH prognosis.