Parameters affecting the anatomical and functional success of macular hole surgery

Esin Kırıkkaya; Süleyman Kaynak

doi:10.19161/etd.1168207

TR EN

Makuler hol cerrahisinin anatomik ve fonksiyonel başarısını etkileyen parametreler

Öz

Amaç: Preoperatif Spectral Domain Optik Koherens Tomografi (SD-OKT) parametrelerinin makuler hol cerrahisi (MHC) üzerindeki etkisini ve bu parametrelerin postoperatif en iyi düzeltilmiş görme keskinliği (EİDGK) için tahmini değerini değerlendirmek. Gereç ve Yöntemler: Bu retrospektif çalışmaya makuler holü (MH) olan 30 hastanın 30 gözü dahil edildi. Tüm hastalara 23-gauge pars plana vitrektomi uygulandı. Preoperatif olarak minimum çap (MÇ), taban çapı (TÇ), açılış çapı (AÇ), yükseklik, nazal kol (NK), temporal kol (TK), makuler hol indeksi (MHİ), çap hol indeksi (ÇHİ), traksiyonel hol indeksi (THİ), hol form faktörü (HFF), makuler hol alanı (MHA) ve makuler hol hacmi (MHV) içeren detaylı bir makula analizi yapıldı. Postoperatif olarak iç-dış segment (IS/OS) bandı, external limitan membran (ELM) ve kist varlığı belirtildi. Bu parametreler ile postoperatif EİDGK arasındaki ilişkiler değerlendirildi. Bulgular: Çalışma grubu 25 (%83,3) kadından oluşuyordu. Pre-postoperatif ortalama EİDGK değerleri sırasıyla 0,924±0,320 ve 0,487±0,287 logMAR idi. EİDGK, MHC'den sonra anlamlı derecede arttı (p<0,001). Postop EİDGK (logMAR) değerleri ile NK (p=0,041), HFF (p=0,048), AÇ (p=0,045) ve MHC öncesi semptom süresi arasında istatistiksel olarak pozitif korelasyon vardı (p=0,032). Postoperatif IS/OS bandı ve ELM varlığı olan hastalarda, olmayanlara göre postoperatif EİDGK anlamlı derecede daha iyi idi (sırasıyla, p=0,002 ve p=0,002). NK, postoperatif IS/OS bandı ve ELM değişkenlerinin postoperatif EİDGK (logMAR) üzerinde etkili oldukları bulundu. Sonuç: Bu çalışmada NK ilk kez prediktif bir faktör olarak belirlendi ve NK ile birlikte IS/OS bandı ve ELM varlığı MHC sonrası görme prognozu için prediktif faktörler olarak belirlendi.

Anahtar Kelimeler

Parameters affecting the anatomical and functional success of macular hole surgery

Abstract

Aim: To evaluate the effect of preoperative Spectral Domain Optical Coherence Tomography (SD-OCT) parameters on macular hole surgery (MHS) and their predictive value for postoperative best corrected visual acuity (BCVA). Materials and Methods: This retrospective study included 30 eyes of 30 patients with macular hole (MH). All patients underwent pars plana 23-gauge vitrectomy. A detailed macular analysis including MH minimum diameter (MD), base diameter (BD), opening diameter (OD), height, nasal arm (NA), temporal arm (TA), macular hole index (MHI), diameter hole index (DHI), tractional hole index (THI), hole form factor (HHF), macular hole area (MHA), and macular hole volume (MHV) were performed preoperatively. Presence of inner segment–outer segment (IS/OS) line, external limiting membrane (ELM), and cyst was noted postoperatively. Relationships between these parameters and postoperative BCVA were evaluated. Results: The study group comprised 25 (83.3%) women. Mean pre and postoperative BCVA values were 0.924±0.320 and 0.487±0.287 logMAR, respectively. BCVA improved significantly after MHS (p<0.001). There was a statistically positive correlation between postop BCVA (logMAR) values, and NA (p=0.041), HFF (p=0.048), OD (p=0.045) and symptom duration before MHS (p=0.032). Postoperative BCVA was significantly better in patients with postoperative IS/OS line and ELM presence compared to those without (p=0.002 and p=0.002, respectively). The NA, postoperative IS/OS and ELM variables were found to be effective on postoperative BCVA (logMAR). Conclusion: In this study, NA was determined as a predictive factor for the first time and together with NA, presence of IS/OS line and ELM were identified as predictive factors for visual prognosis after MHS.

Keywords

Supporting Institution

yok

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Esin Kırıkkaya ^*
0000-0003-1004-9492
Türkiye

Süleyman Kaynak
0000-0001-5587-7238
Türkiye

Publication Date

September 12, 2022

Submission Date

June 9, 2022

Acceptance Date

July 16, 2022

Published in Issue

Year 2022 Volume: 61 Number: 3

DOI

https://doi.org/10.19161/etd.1168207

IZ

https://izlik.org/JA89ZW73YK

Cite

RIS / Bibtex

Vancouver

1.Esin Kırıkkaya, Süleyman Kaynak. Parameters affecting the anatomical and functional success of macular hole surgery. EJM. 2022 Sep. 1;61(3):434-43. doi:10.19161/etd.1168207