Surgical repair of full thickness idiopathic macular holes associated withsignificant macular drusen

Objective: To evaluate the visual and anatomic results of surgically repair ed macular holes in eyes with intermediate or large-sized macular drusen. Design: Retrospective noncomparative case series. Participants: Thirty-four eyes of 32 patients undergoing macular hole surgery with preoperative inte rmediate or large-sized macular drusen as defined by the Age-Related Eye Di sease Study (AREDS). Intervention: Pars plana vitrectomy for standard macular hole repair perfor med by multiple surgeons. Main Outcome Measures: Visual acuity, anatomic hole closure. Results: Initial hole closure failed in 8 eyes (24%) overall, 5 of 28 eyes (18%) with AREDS category 2 drusen and 3 of 6 eyes (50%) with category 3 dr usen (P = 0.1263). Final macular hole closure was seen in 93% of category 2 and 67% of category 3 eyes (P = 0.1347), Mean final visual acuity was 20/6 0 overall, 20/60 for category 2, and 20/50 for category 3 eyes. Conclusions A trend of reduced initial macular hole closure was seen in eye s with significant macular drusen, Reoperation improved closure rates, If c losure was accomplished, visual outcomes were excellent. (C) 2000 by the Am erican Academy of Ophthalmology.