23 August 2024
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According to a study presented at the annual meeting of the American Society of Retina Specialists, previous unsuccessful local therapy does not affect outcomes in patients undergoing surgical macular hole repair.
Gennady Landa, of the New York Eye and Ear Infirmary of Mount Sinai, said that conservative treatment of macular holes with triple topical therapy is effective in most, but not all, patients.
Previous unsuccessful topical therapy does not affect outcomes in patients undergoing surgical macular hole repair. Image: Adobe Stock
“Real-world data show that a significant percentage of patients with macular holes do not respond to local medical therapy and ultimately require surgical intervention,” he said.
Landa and colleagues sought to determine the visual outcomes of patients who failed topical therapy and ultimately underwent macular hole repair surgery. The retrospective study included only patients who had a primary idiopathic full-thickness macular hole and in whom surgery was uncomplicated.
Of the 47 eyes analyzed, 21 had previously been treated unsuccessfully with eye drops and eventually underwent surgery to repair a macular hole. In 26 eyes, surgery to repair a macular hole was performed without prior treatment with eye drops.
Eyes in both groups had significantly improved best-corrected visual acuity postoperatively. Eyes previously treated with eye drops had better BCVA preoperatively and there was a trend toward better BCVA postoperatively, Landa said.
Furthermore, the percentage of macular hole closures was similar in both groups.
Landa said that preoperative BCVA is a known predictive factor for good functional outcomes after macular hole surgery, but that it decreases as the size of the macular hole increases.
“Given the smaller dimensions of both the minimum linear diameter and basal diameter of the macular holes in the eyes that were treated topically before the decision to operate, the better visual outcome could likely indicate that the eyes with the smaller macular holes were selected for medical pretreatment before surgery,” he said. “In selected patients with macular holes, a preoperative trial of eye drops can be safely performed without concern for potential surgical delay in the event of failure of topical therapy.”
Sources/Disclosures
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Landa G. Postoperative visual outcomes in patients with macular hole after failed topical therapy. Presented at: American Society of Retina Specialists Annual Meeting; July 17-20, 2024; Stockholm.
Announcement:
Landa does not provide any relevant financial information.
