Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort

Steel, David; Donachie, Paul H. J.; Aylward, G W; Laidlaw, D A H; Williamson, Tom H.; Yorston, David

doi:10.1038/s41433-020-0844-x

Cited by 98 publications

(116 citation statements)

References 37 publications

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“…We showed a similar macular hole closure rate (96% in 23 gauge and 99% in 25-gauge group) after macular hole surgery compared to other studies with results ranging from 93 to 100% [32][33][34][35].…”

Section: Discussionsupporting

confidence: 80%

Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

et al. 2021

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Purpose To assess and compare safety and effectiveness between 23-gauge and 25-gauge vitrectomy systems for the treatment of common vitreoretinal diseases in non-vitrectomized eyes. Methods Retrospective evaluation of patients who underwent pars plana vitrectomy from April 2018 to December 2019 at the Department of Ophthalmology and Optometry at the Medical University of Vienna (MUV) for the following indications: macular epiretinal membrane, macular hole, macular lamellar hole, vitreous hemorrhage, vitreous opacities, vitreomacular traction syndrome and macular edema. Results 201 eyes of 195 patients that underwent 23-gauge (n = 105 eyes) or 25-gauge (n = 96 eyes) vitrectomy were included in this study. The mean best-corrected visual acuity (BCVA) improved at 1–3 months postoperatively and beyond 3 months in both gauge groups. Risk of any complication within 1 month postoperatively was lower in the 25-gauge group, but the difference was statistically not significant (HR [95% CI]: 0.95 [0.53; 1.70], p = 0.85). Intraocular pressure less than 5 mmHg was observed in 2 eyes (2%) in the 23-gauge group at the first postoperative day. Intraocular pressure elevation over 25 mmHg occurred in 5 eyes (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group) at postoperative day 1, between 7 and 28 days in 5 cases (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group), and in 2 eyes (2%) of the 23-gauge group at postoperative day 145 and 61, respectively. Retinal detachment occurred in 1 eye (1%) in the 23-gauge and in 3 eyes (3%) in the 25-gauge group. We did not observe any cases of endophthalmitis. Conclusion Results in terms of safety, surgical success and visual outcomes for the treatment of common vitreoretinal surgery indications seem to be comparable between 23-gauge and 25-gauge vitrectomy systems, indicating that the two gauge systems can be used equally in the clinical routine.

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Section: Discussionsupporting

confidence: 80%

Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

et al. 2021

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“…We read the paper by Steel et al [1] with great interest and welcome their study demonstrating large macular holes do not behave differently in terms of surgical anatomical closure at the arbitrary "cut-off" value of 400 µm, confirming the findings of our previously study published in 2018 [2]. Whereas we demonstrated that a size of~630 µm appears to represent a significant inflection point where surgical macular hole closure significantly decreases, the BEAVRS dataset suggests a value of~500 µm.…”

Section: To the Editorsupporting

confidence: 86%

Comment on: ‘Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort’

Patton

Jalil

Ivanova

et al. 2020

Eye

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“…Primary surgical repair may fail due to various factors, including persistent vitreoretinal and epiretinal traction, chronicity of the hole, inadequate gas endotamponade, large aperture diameter, high myopia, or MHs with a flat-open configuration [27][28][29][30][31]. The benefit of face-down positioning after MH surgery remains unclear, but it is possible that it may benefit MHs larger than 400 microns [29,32,33].…”

Section: Risk Factors For Failure Of Primary Macular Hole Surgerymentioning

confidence: 99%

Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach

Cao

Kaiser

2021

Ophthalmol Ther

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Primary surgery for macular hole (MH) closure has a high success rate with current methods of pars plana vitrectomy and internal limiting membrane (ILM) peeling. When primary surgery fails, there are several options available for secondary repair, including extension of the ILM peel, creation of an ILM flap, pedunculated ILM flap, lens capsule flap transplantation, autologous retinal transplantation, use of a human amniotic membrane plug, adjuvant autologous platelet concentrate, induction of macular detachments with subretinal blebs, and creation of retinal incisions. In this review, we discuss the practical approach to each of these surgical techniques for the management of recurrent or persistent MHs.

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Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort

Cited by 98 publications

References 37 publications

Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

Comment on: ‘Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort’

Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach

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