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Article Dans Une Revue American Journal of Ophthalmology Année : 2010

Long-term outcome of idiopathic macular hole surgery.


PURPOSE: To evaluate the role of preoperative macular hole (MH) diameter, cataract surgery, and cystoid macular edema (CME) in the reopening of idiopathic macular hole (IMH) after initially successful surgery. DESIGN: Multicenter, retrospective, comparative case series. METHODS: One hundred and thirty patients (135 eyes) with stage 2, 3, or 4 IMH were included after successful IMH repair at Dijon University Hospital or Nancy University Hospital. The eyes were separated into 4 groups according to the lens status: group 1, vitrectomy in pseudophakic eyes; group 2, vitrectomy and cataract extraction as a combined procedure; group 3, vitrectomy followed by cataract extraction; group 4, vitrectomy on eyes that remained phakic. All patients underwent a complete vitrectomy with retinal inner limiting membrane peeling and intraocular gas tamponade. The main outcome measures were IMH closure rate and best-corrected visual acuity. RESULTS: Mean duration of symptoms was 8.6 +/- 7.6 months. The follow-up was 37 +/- 8.6 months (range, 30 to 67 months). The mean preoperative IMH diameter was 454 +/- 191 mum. No MH reopened during the follow-up after the initial vitreous surgery. Seven cases of CME were observed (1 in groups 1 and 2; 5 in group 3), and cataract surgery was performed in the 53 patients in group 3 with a mean delay of 11.6 months. CONCLUSIONS: Cataract extraction, CME, or preoperative MH diameter measured by optical coherence tomography were not identified as risk factors for IMH reopening.

Dates et versions

hal-00680910 , version 1 (20-03-2012)



Marie Passemard, Younes Yakoubi, Aurore Muselier, Isabelle Hubert, Alexandre Guillaubey, et al.. Long-term outcome of idiopathic macular hole surgery.. American Journal of Ophthalmology, 2010, 149 (1), pp.120-6. ⟨10.1016/j.ajo.2009.08.003⟩. ⟨hal-00680910⟩
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