Hasan S M F, Roy P K, Aminul F, Abdullah M, Islam M A, Akhanda M A H
Dr SM Fakhrul Hasan, Medical Officer, Bangladesh Korea Friendship Hospital (Eye Care Unit), Savar, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2025 Jul;34(3):881-886.
Macular hole is a full thickness defect at the centre of macula. Pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade helps to close the hole and improves visual function. Aim of this study was to assess the anatomical and functional outcome following surgery of idiopathic macular hole. This interventional study was conducted in the Department of Vitreo retina, National institute of ophthalmology and hospital, Dhaka from December 2020 to August 2022. A total, 50 patients having idiopathic macular hole were included during the study period according to selection criteria. Preoperative logarithm of minimal angle of resolution (logMAR) visual acuity was measured and Optical Coherence Tomography (OCT) was done for further staging of hole. Pars plana vitrectomy, ILM peeling assisted with Brilliant blue G dye and perfluoropropane gas tamponade was done under local anesthesia. Patients were instructed to maintain a facedown position for two weeks. Postoperatively, patients were examined on day one, day seven, after one and three months. At each follow up visual acuity, ocular examination and measurement of intraocular pressure was done. OCT was done to assess anatomical closure of hole and final visual outcome was measured as best corrected visual acuity (BCVA) at three months after surgery. After data collection data were coded, entered and analyzed in a computer. Statistical test was done by windows software using statistical package for social science (SPSS) statistics for Windows, Version 26.0. Male female ratio was 1:2.3. Among 50 patients, majority (29; 58.0%) were in stage II macular hole. Duration of symptoms was more than five months before surgery in 35(70.0%) patients. Majority of study patients (82.0%) were phakic. Preoperative BCVA was found as 1.48-1.00 logMAR in 33(66.0%) patients. BCVA (0.94±0.13 vs. 0.62±0.26 in logMAR) was significantly (p<0.001) improved after macular hole surgery. Macular hole was closed in majority (45; 90%) of the study patients. Preoperative BCVA and stage of macular hole were significant factors for visual improvement. This study revealed that the overall closure rate of macular hole was satisfactory and BCVA was significantly improved during the last follow up.
黄斑裂孔是黄斑中心的全层缺损。玻璃体视网膜手术联合内界膜（ILM）剥除及气体填充有助于封闭裂孔并改善视功能。本研究的目的是评估特发性黄斑裂孔手术后的解剖和功能结果。本干预性研究于2020年12月至2022年8月在达卡国家眼科研究所和医院的玻璃体视网膜科进行。根据入选标准，在研究期间共纳入50例特发性黄斑裂孔患者。测量术前最小分辨角对数（logMAR）视力，并进行光学相干断层扫描（OCT）以进一步对裂孔进行分期。在局部麻醉下进行玻璃体视网膜手术、用亮蓝G染料辅助剥除ILM及全氟丙烷气体填充。指导患者保持俯卧位两周。术后，在第1天、第7天、1个月和3个月后对患者进行检查。每次随访时均进行视力、眼部检查及眼压测量。进行OCT以评估裂孔的解剖学封闭情况，并将最终视力结果测量为术后3个月时的最佳矫正视力（BCVA）。数据收集后进行编码、录入并在计算机上进行分析。使用Windows软件的社会科学统计包（SPSS）统计学版本26.0进行统计检验。男女比例为1:2.3。在50例患者中，大多数（29例；58.0%）为II期黄斑裂孔。35例（70.0%）患者术前症状持续时间超过5个月。大多数研究患者（82.0%）有晶状体。33例（66.0%）患者术前BCVA为1.48 - 1.00 logMAR。黄斑裂孔手术后BCVA（logMAR为0.94±0.13 vs. 0.62±0.26）有显著改善（p<0.001）。大多数（45例；90%）研究患者的黄斑裂孔闭合。术前BCVA和黄斑裂孔分期是视力改善的重要因素。本研究表明，黄斑裂孔的总体闭合率令人满意，且在最后一次随访时BCVA有显著改善。
