Surgical Outcome of Mini-Invasive Surgery for Primary Macular Holes.

Introduction/Background: Treatment of macular holes (MH) has always been a challenge for vitreo-retinal surgeons. Moreover, surgical approach is still debated for the management of lamellar holes (LH). Methods: We retrospectively analysed baseline, procedural and follow-up data of patients undergoing vitreo-retinal surgery for MH at Desio Hospital in the period 1st January 2012 - 30th June 2015. We considered only patients affected by primary macular holes with a follow-up of at least 6 months. We divided our population in two sub-groups: patients affected by full thickness hole (FTH) and those affected by lamellar hole (LH). Primary end-point was the rate of closure of MH; the secondary endpoints were final LogMAR BCVA outcome and the occurrence of adverse events. Subgroup analysis was also performed. Results: A total of 85 patients were included: 63 (74%) in the FTH group, 22 (26%) in the LH group. The follow-up interval is 25.2 months (range 6-47). At last follow up visit we report a rate of MH closure in 76/85 eyes (89%). Of the 9 eyes without MH closure three were from the LH subgroup (13%). At baseline BCVA was 0.41 ± 0.19 and 0.31 ± 0.21 for LH and FTH groups, respectively (p = 0.40). Overall, we registered a significant improvement of mean BCVA after VR surgery (0.36 ± 0.21 at baseline vs. 0.54 ± 0.26 at final follow-up visit, P = 0.03), but the subgroup analysis showed no statistically significant improvement in the LH subgroup (0.41 ± 0.19 vs. 0.49 ± 0.24; p = 0.38). Of the 9 eyes without MH closure, 4 (44%) underwent a re-intervention with success, 4 (44%) maintained a stable BCVA and one (12%) underwent a rescue treatment for adverse event (retinal detachment). Conclusions: Our results supports the efficacy of surgical approach in the management of FTH. Conversely, in our experience LH treatment did not reveal significant functional improvement. Acknowledgements: No conflict of interest. [ABSTRACT FROM AUTHOR]