Long-term follow-up after vitrectomy to treat idiopathic full-thickness macular holes: visual acuity and macular complications

Abstract

Hirokazu Sakaguchi,1 Masahito Ohji,2 Yusuke Oshima,1 Yasushi Ikuno,1 Fumi Gomi,1 Naoyuki Maeda,1 Motohiro Kamei,1 Shunji Kusaka,3 Kohji Nishida11Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, 2Department of Ophthalmology, Shiga University of Medical Science, Otsu, 3Department of Ophthalmology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, JapanBackground: To assess time-course changes in best-corrected visual acuity (BCVA) up to 5 years after vitrectomy to treat idiopathic full-thickness macular holes (MHs) and identify the relationship of the changes to postoperative complications.Methods: Twenty-three consecutive patients with an idiopathic MH underwent vitrectomy without adjuvant treatment. BCVA and complications were assessed postoperatively.Results: Twenty-two of 23 (95.7%) MHs closed after the first surgery, with a final anatomic success rate of 100%. The time course of the BCVA was analyzed in 20 cases in which data were obtained for over 5 years. The BCVA improved by 0.43 logarithm of the minimum angle of resolution (logMAR) unit 6 months postoperatively (P < 0.001) and continuously improved by 0.05, 0.06, and 0.07 logMAR units between 6 months and 1 year, 1 year and 3 years (by 0.11 logMAR unit between 6 months and 3 years; P = 0.049), and 3 years and 5 years (P = 0.018) postoperatively, respectively. Macular complications developed in seven (35%) of the 20 cases; the mean BCVA at 5 years in these cases was significantly (P < 0.001) worse than in cases without complications.Conclusion: The BCVA might improve gradually for 5 years after vitrectomy to treat MHs. However, the macular complications that can develop postoperatively could limit that possibility.Keywords: macula hole, time course, vitrectomy, retina, visual acuity, complication