First-Operated and Fellow Eyes With Bilateral Idiopathic Macular Hole: Comparison of Anatomical and Functional Postoperative Outcomes.

Background And Objective: To report anatomical and functional outcomes of surgery in each of the eyes in cases of bilateral macular hole (MH).

Patients And Methods: The anatomical and functional results for 42 patients with bilateral idiopathic MH were evaluated retrospectively. First-operated and fellow eyes were compared at various time points for preoperative characteristics and postoperative outcomes.

Results: Anatomical success was achieved in all patients after a single operation, and no reopening of an initially closed MH was observed during the follow-up period. There was a statistically significant difference between the first and fellow eyes in mean postoperative logMAR visual acuity (VA) (P = .048). Fellow eyes had better postoperative VA, lower rates of ellipsoid zone, and interdigitation zone disruption, and none of the fellow eyes had external limiting membrane disruption at any time after surgery.

Conclusions: Although anatomical success can be achieved in both eyes after successful surgery, early detection and treatment of fellow eyes is associated with better postoperative VA. The reason for a better outcome in the fellow eye is related to the lower photoreceptor impairment rate because of the earlier stage of the hole. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:571-578.].