Ultrahigh-Resolution Optical Coherence Tomography of Surgically Closed Macular Holes

Abstract

Since the introduction of vitrectomy for the treatment of macular hole in 1991, vitreous surgery has become the standard in therapy for the disease.¹ The procedure has undergone numerous improvements with increasing success rates. Success has been defined in terms of anatomical closure and improvement of visual acuity. With the addition of internal limiting membrane (ILM) peeling to the surgical procedure, recent anatomical closure rates of 85% to 100% and visual acuity improvement rates of 85% to 95% have been reported.^2-6 Although functional success is fairly simple to assess via best-corrected visual acuity (BCVA), anatomical success is more difficult to define. In 1998, Tornambe et al⁷ defined the following 3 surgical end points based on fundus examination that have since been widely accepted: elevated/open, flat/open, and flat/closed. These anatomical end points correlated with visual acuity after surgery.