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¹M.D., Ankara Ulucanlar Eye Training and Research Hospital, Ankara/TURKEY
²M.D., Torbalı State Hospital, Eye Clinic, Torbalı-İzmir/TURKEY
³M.D. Asistant Professor, Ege Universit Faculty of Medicine, Department of Biostatistics and Medical Informatics, İzmir/TURKEY
⁴M.D. Professor, Ankara Ulucanlar Eye Training and Research Hospital, Ankara/TURKEY Purpose: To evaluate postoperative anatomical and visual results of patients with idiopathic macular hole (IMH).
Materials and Methods: In this retrospective study, 167 patients aged between 44-79 years underwent 23 gauge transconjunctival pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Phacoemulsification and intraocular lens implantation were performed in 72 cases as additional operations. During the follow-up period, anatomical and functional success and complications were evaluated. Age, symptom duration, preoperative visual acuity, hole diameter and stage, lens status, operation type, paint and internal tamponade used in surgery were the factors, which were evaluated for their effects on anatomical and functional success.
Results: The average duration of blurred vision and/or metamorphopsia of cases were 10.0±5.2 months. Twenty-seven (16.2%), eighty-six (51.5%) and fifty-four (32.3%) patients had stage 2, -3, and -4 macular hole, respectively. The closure rate following a single operation was 146/167 (87.4%). Postoperatively visual acuity was increased in 116 eyes (69.5%) while remaining the same in 47 (28.1%) and decreasing in 4 (2.4%) patients. As analyzed by multiple logistic regression model, symptom duration, hole diameter, and used paint were found to be associated with anatomical failure (odds ratios were: 1238, 1014 and 5.079, respectively; all p values, <0.05), symptom duration was detected to be the only factor causing functional failure (odds ratio: 1.082, p=0.15).
Conclusion: Pars plana vitrectomy, ILM peeling and the use of intravitreal gas tamponade are standard and successful treatment in IMH surgery and provide satisfactory anatomical and functional results. Keywords : Macular hole, 23-gauge transconjunctival pars plana vitrectomy, internal limiting membrane