Outer retinal defects represent a normal recovery pathway following internal limiting membrane peeling in macular hole surgery

Abstract

BACKGROUND AND OBJECTIVE: To examine perioperative factors associated with the development of outer retinal defects (ORDs) following surgical repair of macular holes (MHs). PATIENTS AND METHODS: An institutional review board-approved, retrospective, interventional cohort study was conducted. Patients who underwent MH repair during a 5-year period were identified. Statistical analysis was conducted to detect significant perioperative associations to ORD development. RESULTS: One hundred twenty-four eyes were included, and 54% developed an ORD following surgery. These defects correlated with lower preoperative stage (P = .0057), preoperative phakia (P = .036), and lack of prior macular surgery (P = .0016). Patients in the ORD group had significantly better preoperative and postoperative visual acuity (P = .031 and P = .0004, respectively), but there was no difference in change in acuity from preopera-tively to 3 months postoperatively when compared with control patients (P = 42). The majority (89%) of ORDs resolved by 24 months postoperatively. CONCLUSION: The development of ORDs appears to be correlated with several factors indicative of favorable overall eye health and less advanced pathology and may represent a normal state of recovery after MH repair with internal limiting membrane peeling.