Optical coherence tomography of successfully repaired idiopathic macular holes

PURPOSE: To present the cross-sectional retinal imaging results of optical coherence tomography in eyes with successfully repaired idiopathic macular hole and their relevance to visual recovery, METHODS: We studied 33 eyes with successful repair of an idiopathic macular hole through vitrectomy and fluid-gas exchange from 32 patients (11 men an d 21 women) with ages ranging from 48 to 78 years, with a median age of 66 years, Preoperative conditions in eyes with primary surgery disclosed nine eyes with stage 2, 14 eyes with stage 3, and four eyes with stage 4 macular hole, An additional six eyes underwent a second surgery because the previo us surgery was unsuccessful, Measurement of best-corrected visual acuity, s lit-lamp biomicroscopy with fundus contact lens, fundus photographs, and op tical coherence tomographic examination were performed between 6 and 9 mont hs after surgery in 29 eyes and between 15 and 36 months after surgery in f our eyes. RESULTS: Optical coherence tomographic images of the repaired macular holes were categorized into three patterns, U-type (normal foveal contour; 13 ey es) showed mildly to moderately backscattering layers with a smooth circula r surface covering retinal pigment epithelium and choriocapillaris layers, In eyes with V-type (steep foveal contour; 13 eyes), the retinal pigment ep ithelium and choriocapillaris layers were covered with moderately backscatt ering layers with a notch, W-type (foveal desfect of neurosensory retina; s even eyes) showed abruptly or gradually terminating sensory retinal layers to expose the surface of the retinal pigment epithelium and choriocapillari s layers, Postoperative acuity was well correlated with these patterns of o ptical coherence tomographic images, CONCLUSION: Assessment of successfully repaired idiopathic macular holes wi th optical coherence tomographic images provides a useful correlation with postoperative visual recovery, (C) 1999 by Elsevier Science Inc, All rights reserved.