Factors on Visual Acuity İmprovement in Patients who Underwent Surgery for İdiopathic Macular Hole

İdiopatik Maküla Deliği Cerrahisinde Görme Keskinliği Artışı Üzerine Etkili Faktörler

Mehmet Şehmus ASLAN,Mustafa GÖK,Berna ÖZKAN,Çiğdem AKDAĞ KOÇER,V. Levent KARABAŞ

Abstract

Purpose: To assessment effects of factors on visual acuity improvement in patients who underwent surgery for idiopathic macular hole (IMH).Material and Methods: In this retrospective study records of 35 patients who were operated due to IMH, were examined. All the patients had unilateral Stage 2, 3 and 4 IMH. 23 gauge transconjunctival pars plana vitrectomy (PPV) was performed in 19 patients and also 20 gauge PPV in 16 patients. In all patients, internal limiting membrane (ILM) was peeled. C3F8 gas tamponade was used in 26 patients, and also SF6 gas in 7 patients, air in 1 patient, silicone oil in 1 patient. After the operation patients were kept on prone position for five days.Results: 12 of the patients were male (34.3%), 23 of them female (65.7%) and the mean age was 65.06±10.7 years. A statistically significant positive correlation was determined between the preoperative initial and postoperative final visual acuity(p<=0.001). A statistically significant negative correlation was observed between the increase in visual acuity, final best corrected visual acuity (BCVA) and average duration of complaints (6.74±5.18 months), (p<=0.05), mean postoperative central macular thickness (304.77±67.10 microns). Final BCVA and postoperative visual improvement in Stage 4 IMH cases were statistically significant less than in stage 2 and 3 (p<=0.05) and there was also no difference between stage 2 and 3 IMH cases (p>=0.05). Mean time to reach final visual acuity and mean normal foveal morphology formation time of the patients were 6.69±2.27 months (4-13 months) and 2.80±1.51 months (1-7 months), respectively.Discussion: The initial visual acuity, duration of complaints, postoperative central macular thickness, hole stage seems to be influential prognostic factors on BCVA improvement

Özet

Amaç: İdiyopatik makula deliği (IMD) nedeniyle cerrahi uygulanan hastalarda görme keskinliği artışı üzerine etkili olan faktörlerin değerlendirilmesi.Gereç ve Yöntem: Bu geriye dönük çalışmada IMD nedeniyle opere edilen 35 hastanın kayıtları incelendi. Hastalarda tek taraflı Evre 2, 3 ve 4 IMD mevcuttu. 19 hastaya 23 gauge transkonjonktival pars plana vitrektomi (PPV) ve 16 hastaya 20 gauge PPV uygulandı. Bütün hastalarda internal limitan membran (ILM) soyuldu. İnternal tamponad olarak 26 hastada C3F8 gazı, 7 hastada SF6 gazı, 1 hastada hava, 1 hastada silikon yağı kullanıldı. Hastalara operasyondan sonra 5 gün yüzüstü yatış pozisyonu verildi.Bulgular: Hastaların 12 si erkek (%34.3) 23 tanesi kadın (%65.7) ve yaş ortalaması 65.06±7.10 yıl idi. Başlangıç görme keskinliği yüksek olan olguların sonuç görme keskinliklerinin de yüksek olduğu görüldü (p =0.05) Olguların sonuç görme keskinliğine ulaşma zamanı ortalama 6.69±2.27 ay(4-13ay), normal foveal morfoloji oluşum süresi ortalama 2.80±1.51 ay (1-7 ay) olarak belirlendi.Sonuç: Başlangıç görme keskinliği, şikayet süresi, postoperatif santral makula kalınlığı, makula deliği evresi; görme artışı ve sonuç en iyi düzeltilmiş görme keskinliği (EDGK) üzerindeki etkili prognostik faktörler olarak gözükmektedir