The Surgical Results of Vitrectomy for Macular Holes, according to the Hole Size

Purpose: To evaluate the surgical results of vitrectomy for macular hole, according to the hole size. Methods: Fifty-six patients (58 eyes) who had macular hole surgery without any complication influencing visual acuity were included in this study. They were divided into three groups by the size of the hole: Group 1 (smaller than 1/4 disc diameter), Group 2 (1/4 disc diameter or larger but smaller than 1/2 disc diameter), and Group 3 (1/2 disc diameter or larger). We compared the anatomical and functional results of these groups. Results: The mean follow-up durations after surgery were 14.4 months (Group 1), 15.9 months (Group 2), and 27.5 months (Group 3) months. In 3, 6, and 3 cases in each group respectively, the holes were re-opend and among them, 2, 4, and 3 cases were closed by reoperation. Mean pre-operative visual acuity was 0.15, 0.09, 0.08 and the percentage of the cases achieving 2 lines or more improved visual acuity after surgery was 69.2%, 76.5%, and 72.7%, but the mean post-operative best corrected visual acuity was 0.45, 0.30, 0.17 for the three groups, respectively. This shows that smaller holes had the better post-operative visual acuity. The percentage of hole-occlusion in the three groups was 84.6%, 94.1%, and 90.9%, and that of invisible holes was 76.9%, 82.4%, and 72.7% respectively. Conclusions: This study shows that the size of macular holes does not significantly influence surgical results. but large-sized macular holes lead to poor post-operative visual acuity. J Korean Ophthalmol Soc 47(6):927-932, 2006