Macular Hole Surgery Improves Visual Acuity, Regardless of Type

Retinal Detachment, Surgery
Ophthalmology surgery, Pasteur 2 Hospital, Nice, France, treatment of a retinal detachment through vitrectomy, The doctor is helped by an intern. (Photo by: BSIP/Universal Images Group via Getty Images)
Whether patients have a tractional or degenerative macular hole, pars plana vitrectomy can aid their visual functioning.

Pars plana vitrectomy (PPV) can successfully treat lamellar macular hole (LMH) and improve functional outcomes, regardless of the patient’s LMH type, or surgical approach, according to a study published in Clinical Ophthalmology. 

The retrospective multicenter cross-sectional study examines the results of PPV in patients treated for LMH. Researchers included patients who underwent PPV alone, a combined phaco-vitrectomy. Researchers reviewed the patients’ functional changes before and after surgery, and anatomical changes measured optical coherence tomography (OCT).

In total, researchers included 66 participants (mean age of 71.79± 8.52). The subtypes of LMH recorded in participants included tractional type (47 participants, 71.2%) and degenerative type (19 participants, 28.8%). Additionally, 63 participants (95.5%) had epiretinal membrane (ERM), 19 participants (28.8%) had LMH-associated epiretinal proliferation (LHEP), and 16 (24.2%) had concomitant ERM and LHEP. 

Four degenerative type and 27 tractional type participants received a combined phaco-vitrectomy, while the remaining 33 participants underwent PPV alone (23 g, 25 g or 27 g). Patients were also stratified by tamponade types with 17 participants (25.7%) receiving gas-tamponade, 26 (39.4%) air-tamponade, and 23 (34.9%) balanced salt solution-tamponade. 

BCVA improved significantly for the entire cohort, as well as independently for those who had tractional LMHs, degenerative LMHs, and for both the PPV alone and combined phaco-vitrectomy groups. It also improved for all tamponade groups, but the air tamponade groups did not demonstrate significant improvement. None of the groups showed any decrease in acuity after either procedure. 

The study was limited in that it lacked inpatient postoperative examinations at 1 location, preventing access to OCT parameters following the procedures. Also, since researchers utilized multiple centers in this study, the exact timing of postoperative examinations and improvements were not consistently documented throughout. Finally, researchers did not exclude participants with comorbidities.


Haave H, Petrovski BE, Zając M, et al. Outcomes from the retrospective multicenter cross-sectional study on lamellar macular hole surgery. Clin Ophthalmol. Published online June 8, 2022. doi:10.2147/OPTH.S351932