Abstract

P 196

Functional result of macular hole surgery

R. J. Zhang1, Lothar Krause2, Michael H. Foerster3
1Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, P. R.China, 2Augenklinik, Städtisches Klinikum Dessau, Dessau, 3Augenklinik, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin

Objective
The aim of this retrospective study was try to examinate the clinical factors, optimal method and timing of the surgical treatment for macular holes (MH).
Methods
The study reviewed consecutive case series including 825 eyes of 752 patients (224 men and 528 women, median age 65,9±9,7 years ) who underwent Pars plana Vitrectomy (PPV) in case of MH during 1994 and 2008. Patients with a follow-up period of less than 3 months were excluded. The data were analysed retrospectively. For the statistical univariate and multivariate analyses we used nonparametric test, independent-sample T test, Pearson chi-square or Fisher two-tail exact test and stepwise logistic regression test respectively.
Results
MH was found in stage I (7 eyes), II (94 eyes), III (363eyes), IV (361 eyes) at initial surgery, with a median age of 60 years and a median follow-up of 42.1 months. Success rate of first operation was 89,7%(740 eyes), there are 72 eyes underwent the second surgery with stage III (16 eyes) and IV (56 eyes), the success rate was 86,1%(62 eyes); 7 eyes had a third time with stage III(1 eye) and IV (6 eyes), 71,4%(5 eyes achieved anatomical closure in MH. The MH was closed in 799 (96.8%) eyes after one or more operations，11 (1.3%) eyes remain open after surgery, and 15 (1.8%) eyes reopened after a period of time afer operation. There were no significant differences noted for different stages with initial failure (P=0.161). The initial success rate in eyes using ILM peeling was significantly better than those without peeling (P=0.001), and combined with dye was even significantly better than those without dye.
Conclusions
A high rate of anatomical closure and comparatively better final VA were achieved by using PPV, our reseach suggests that ILM peeling and with the help of dye can improve the success rate of the surgery and there was not significantly different for visual field defect with different type or concentrated dye.

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