ZongMing Song
Henan Eye Hospital,China
Title: Different Surgical Strategies for Different Macular Holes A New Classification System of Full-Thickness Macular Holes
Biography
Biography: ZongMing Song
Abstract
Methods
A total of 221 patients (241 eyes) diagnosed with FTMH were enrolled over a 6-year period between 2013 to 2019. The chosen surgical methods for FTMH of different diameters included pars plana vitrectomy (PPV), gas tamponade, flute-needle aspiration, ILM operation (peeling, scraping, inverted ILM flap, insertion, transplantation), and autologous blood clot (ABC). Anatomical and functional outcomes pre- and post-surgery were evaluated.
Results
Based on clinical experience, the patients with FTMH were classified into five groups (small: <300μm; medium: ≥300μm and <600μm; large: ≥ 600μm and < 900μm; huge: ≥900μm; recurrent). Best-corrected visual acuity (BCVA) significantly improved from 0.88 ± 0.44 to 0.56 ± 0.49 in small MH (P = .0007), 0.98 ± 0.39 to 0.70 ± 0.41 in medium MH (P < .0001), 1.24 ± 0.48 to 0.98 ± 0.38 in large MH (P = .0004), 1.16 ± 0.25 to 0.91 ± 0.34 in huge MH (P = .044), and 1.16 ± 0.28 to 0.93 ± 0.21 in recurrent MH (P = .204). The closure rates of the five types were as follows: FTMH, 100% (37/37) in small MH; 97.9% (94/96) in medium MH; 94.1% (80/85) in large MH; 93.7% (15/16) in huge MH; 57.1% (4/7) in recurrent MH, with significant differences (P < .001).