Anatomical And Visual Outcome Following Macular Hole Surgery At Tertiary Eye Care Centre Of Nepal

Raba Thapa MD, Govinda Paudyal MD

Vitreo-retina Service, Tilganga Institute of Ophthalmology, Kathmandu, Nepal.

Purpose: The study aims to explore the anatomical and visual outcome following pars plana vitrectomy (PPV) in cases with macular hole.

Methods: 36 consecutive cases of macular hole treated with PPV, membrane peeling, gas (C3F8) and face down positioning for a week from 2007 January to 2010 August were retrospectively reviewed in this study. Macular anatomy was assessed using optical coherence tomography at 6 weeks, 3 months and at last follow-up following the surgery.

Results: The mean age was 53.2 years (19.3 S.D) and mean duration of decreased vision 11.1 months (12.1 S.D). Idiopathic etiology comprised of 86.1% and rest due to trauma. Last follow up period ranged 3-36 months (mean duration 9.4 months). The anatomical success rate was 75% at 6 weeks and 77.8% at 3 months and last follows up. Vision was improved in 33.3% of cases with more than 2 lines in 27.8 % of cases, stable in 27.7% of cases during the last follow up. Only 16.67% of cases underwent cataract surgery. Anatomical success (80.65%) and visual improvement (45%) was higher in idiopathic origin than in traumatic origin (60%) and 20% respectively. The anatomical success and visual improvement by > 2 lines was 100% with MLD of macular hole < 400 micron.

Conclusions: Anatomical and visual success following macular hole surgery were comparable to other studies. The success rate was higher among the idiopathic group, and lesser MLD of macular hole.

Key words: Macular hole, Vitrectomy, Anatomical success, visual acuity