Anatomical and Functional Outcomes of Pars Plana Vitrectomy for Lamellar Macular Defects.

Abstract

The aim of this study is to investigate the anatomical and functional outcomes of surgical management of lamellar macular defects. This study is a retrospective observational case series. Overall, the records of 89 eyes of 78 consecutive patients with a clinical diagnosis of either lamellar macular hole, macular pseudohole, or foveal pseudocyst were reviewed. Twenty-one (23.6%) of the 89 eyes underwent pars plana vitrectomy by a single ophthalmologist. Preoperative and postoperative visual acuities (VAs) were compared, and the anatomical outcome of vitrectomy was examined by studying the restoration of the foveal contour on optical coherence tomography (OCT) scans. Comparisons of visual acuity and OCT measurements between vitrectomized and nonvitrectomized eyes were made. Comparisons were also made between the 3 different types of lamellar macular defects. Anatomical closure of the lamellar macular holes was achieved with a single surgical procedure in all vitrectomized eyes as confirmed by OCT. Visual acuity improved in 15 eyes (71%), from 0.39 ± 0.30 logMAR preoperatively to 0.26 ± 0.19 logMAR postoperatively (t20 = 2.425; P = 0.025). Macular pseudohole was associated with better presenting VA (F2,86 = 8.524; P < 0.001) and postoperative VA (F2,18 = 8.920; P = 0.002) than the other types of lamellar defects. Better postoperative VA was significantly correlated with better preoperative VA (r = 0.579; P = 0.006) and greater preoperative central foveal thickness (r = -0.535; P = 0.012). Pars plana vitrectomy provided a high success rate of anatomical and functional improvement for eyes with all types of lamellar macular defects.