Idiopathic macular holes are today treated surgically with good result
s. The prognostic value of factors predictive for the anatomical and f
unctional outcome has not been completely evaluated. Patients and meth
ods: One hundred and thirty-five eyes with penetrating macular holes (
stage II-IV) were investigated prospectively. The mean follow-up was 1
9.5 months (6-50 months). Results: In 86% of cases the hole was closed
postoperatively. The age of the macular hole proved to be a significa
ntly predictive factor for the outcome; the age of the patient did not
. The diameter of the hole showed no influence on the results. Applica
tion of autologous serum in front of the hole did not significantly im
prove the anatomical, but the functional results. The strongest improv
ement of visual acuity was seen in eyes with poor preoperative functio
n. In 118 eyes a prefoveal membrane could be peeled off. Seventeen eye
s without detectable membrane showed identical results. Conclusion: So
me predictive factors in macular hole surgery are proven, others remai
n uncertain. Identical results in eyes with and without prefoveal memb
ranes support the assumption of different pathomechanisms in macular h
ole formation.