Functional and morphologic outcomes after reoperation for persistent idiopathic macular hole



To determine the relationship between preoperative and postoperative characteristics and visual outcomes after successful surgery for unclosed macular hole (MH).


The medical charts of 166 eyes of 161 patients who underwent vitrectomy for a MH were reviewed. The MH was not closed in 9 eyes of 9 patients after the initial surgery. The second vitrectomy with additional internal limiting membrane (ILM) peeling and gas tamponade was performed. The preoperative and postoperative best-corrected visual acuity (BCVA), optical coherence tomographic images, MH size, duration of MH before the first operation, and area of ILM peeling were studied.


The MH was closed in all eyes after the second surgery. The BCVA significantly improved from 0.77 to 0.25 logMAR units (20/118 to 20/36, p = 0.002). The postoperative subfoveal ellipsoid zone (EZ) was distinct and continuous in 3 eyes with good visual recovery. The final BCVA was not significantly correlated with the baseline characteristics and area of ILM peeling but was correlated with the postoperative status of the EZ.


All MHs were closed and the mean postoperative visual acuity was significantly improved. The reason for poor visual recovery was the reduced microstructural recovery after the second surgery.

Eur J Ophthalmol 2017; 27(2): 231 - 234




Akira Hagiwara, Takayuki Baba, Tomoaki Tatsumi, Eiju Sato, Toshiyuki Oshitari, Shuichi Yamamoto

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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  • Department of Ophthalmology, Teikyo University Chiba Medical Center, Chiba - Japan
  • Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba - Japan

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