Long-term Visual Outcomes in Patients with Successful Macular Hole Surgery

Abstract

The purpose of the study is to determine the long-term visual outcomes in patients undergoing successful macular hole surgery. A consecutive series of eyes with an anatomically successful macular hole surgical result and at least 1 year postoperative follow-up information was identified and studied. Preoperative and postoperative visual acuities were measured in accordance with the Early Treatment Diabetic Retinopathy Study protocol. Visual acuity, improvement of visual acuity, and rate of final visual greater than or equal to 20/40 were measured. The median visual acuity increased from 20/125 before surgery to 20/50 1 year after surgery (93 eyes) and to 20/30 at 36 months after surgery (68 eyes). The trend for improvement in visual acuity after 1 year after surgery was statistically significant. The postoperative visual acuity was greater than or equal to 20/40 in 15 (17%) eyes at 3 months and 53 (78%) at 36 months. Before surgery, 12 (13%) eyes were pseudophakic, and 77 (83%) were pseudophakic at 36 months. Median visual acuity in the fellow eye was 20/32 at baseline and 20/32 at 36 months. The visual acuity in the study eye was better than in the fellow eye in 36 (39%) patients at 36 months after surgery. Visual acuity in patients after anatomically successful macular hole surgery continues to improve even beyond 1 year after surgery. Although substantial improvement occurs soon after cataract extraction, further improvement in visual acuity continues for 2 years thereafter.