Preoperative prognostic factors for macular hole surgery: Which is better?

Aim: This study aims to evaluate the prognostic factors of different optical coherence tomography (OCT) parameters as well as the tamponade used in surgery, on postoperative anatomical and functional success.

Methods: Twenty-nine eyes of 27 patients were included in this study. A three-port 23-gauge pars plana vitrectomy was performed on all eyes with peeling of the internal limiting membrane by visualization with brilliant blue dye by the same surgeon (E.U). Apical diameter (AD), base diameter (BD), and height (H) were manually measured by the same retina specialist (E.U) with using the software on OCT machine. Macular hole index (MHI), tractional hole index, diameter hole index, and macular hole volume (MHV) were calculated. The correlation between predictive factors and postoperative best corrected visual acuity (BCVA) was evaluated.

Results: A statistically significant positive correlation was observed between preoperative BCVA, AD, BD, MHV, and postoperative BCVA scores. A statistically significant negative correlation was observed between preoperative MHI and postoperative BCVA scores ( = -0.676, = 0.001). The strongest positive correlation was between BD and postoperative BCVA (logMAR) ( = 0.732, = 0.001). The visual improvement was statistically better in patients treated with C3F8 than SF6.

Conclusion: BD and MHV could be used as a strong predictive OCT parameters of postoperative functional success.