Long-term follow-up after vitrectomy to treat idiopathic full-thickness macular holes: visual acuity and macular complications

BACKGROUND: To assess time-course changes in best-corrected visual acuity (BCVA) up to 5 years after vitrectomy to treat idiopathic full-thickness macular holes (MHs) and identify the relationship of the changes to postoperative complications. METHODS: Twenty-three consecutive patients with an idiopathic MH underwent vitrectomy without adjuvant treatment. BCVA and complications were assessed postoperatively. RESULTS: Twenty-two of 23 (95.7%) MHs closed after the first surgery, with a final anatomic success rate of 100%. The time course of the BCVA was analyzed in 20 cases in which data were obtained for over 5 years. The BCVA improved by 0.43 logarithm of the minimum angle of resolution (logMAR) unit 6 months postoperatively (P < 0.001) and continuously improved by 0.05, 0.06, and 0.07 logMAR units between 6 months and 1 year, 1 year and 3 years (by 0.11 logMAR unit between 6 months and 3 years; P = 0.049), and 3 years and 5 years (P = 0.018) postoperatively, respectively. Macular complications developed in seven (35%) of the 20 cases; the mean BCVA at 5 years in these cases was significantly (P < 0.001) worse than in cases without complications. CONCLUSION: The BCVA might improve gradually for 5 years after vitrectomy to treat MHs. However, the macular complications that can develop postoperatively could limit that possibility.