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Risk Factors and Outcomes of Postoperative Macular Hole Formation after Vitrectomy for Myopic Traction Maculopathy

医学 玻璃体切除术 黄斑病 黄斑裂孔 扁平部 眼科 优势比 内界膜 置信区间 视网膜脱离 入射(几何) 视力 外科 视网膜 视网膜病变 内科学 糖尿病 内分泌学 物理 光学
作者
Taku Wakabayashi,Nobuhiko Shiraki,K. Tsuboi,Yusuke Oshima,Kentaro Abe,Yuki Yamamoto,Hisashi Fukuyama,Keita Baba,Yuichiro Ishida,Yuki Otsuka,Akihiko Shiraki,Masaki Suzue,Ryuya Hashimoto,Ramesh Venkatesh,Jay Chhablani,Fumi Gomi,Motohiro Kamei,Takatoshi Maeno,Carl D. Regillo,Yoshihiro Yonekawa
出处
期刊:Ophthalmology Retina [Elsevier BV]
卷期号:7 (9): 779-787 被引量:3
标识
DOI:10.1016/j.oret.2023.05.017
摘要

To evaluate the incidence, pathogenesis, risk factors, and treatment outcomes of postoperative macular hole (MH) after pars plana vitrectomy (PPV) for myopic traction maculopathy (MTM). Multicenter, interventional, retrospective case series. Consecutive eyes that underwent PPV for MTM with a minimum 6-month follow-up. We investigated the characteristics and treatment outcomes of postoperative MH after MTM surgery. Incidence, risk factors, and anatomic and visual outcomes of postoperative MH. We included 207 eyes (207 patients) with a mean follow-up of 25.9 months. During follow-up, 24 (11.6%) eyes developed MH (10 with concurrent MH retinal detachment); 15 eyes within 30 days (early), 4 eyes between 31 and 180 days (intermediate), and 5 eyes after 180 days (late). Logistic regression analysis revealed male gender (odds ratio [OR], 2.917; 95% confidence interval [CI], 1.198–7.100; P = 0.018), thinner preoperative choroidal thickness (OR, 0.988; 95% CI, 0.976–1.000; P = 0.048), and use of indocyanine green for internal limiting membrane peeling (OR, 2.960; 95% CI, 1.172–7.476; P = 0.022) as significant risk factors for postoperative MH. Internal limiting membrane peeling with a fovea-sparing technique tended to protect against postoperative MH, but it was not statistically significant (P = 0.096), because 1 eye still developed MH. Postoperative MHs were treated by observation (6 eyes), in-office octafluoropropane (C3F8) gas injection (7 eyes), or PPV (11 eyes). Macular hole closure was achieved in 20 eyes (83%). The hole closure rate was 67% (4/6 eyes) after observation, 71% (5/7 eyes) after C3F8 gas injection, and 91% (10/11 eyes) after PPV. However, visual outcomes were significantly worse for eyes with postoperative MH than those without (0.38 ± 0.43 vs. 0.68 ± 0.46; P = 0.002). Postoperative MH may occur in 11.6% of patients with MTM at any time after surgery. Retreatment resulted in relatively favorable anatomic closure but unfavorable visual outcomes. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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