PROGNOSIS OF MACULAR HOLE SURGERY

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.