Our Summary

This study examined the occurrence, causes, risk factors, and treatment results of a condition called macular hole (MH) that can occur after a surgical procedure to treat a vision problem related to nearsightedness, called myopic traction maculopathy (MTM). The study looked back at cases of patients who had this surgery and followed up with them for at least 6 months.

Out of 207 patients, 24 (roughly 12%) developed a MH after their surgery. The study found that being male, having a thinner part of the eye called the choroid before surgery, and using a specific dye in the surgery were all significant risk factors for developing a MH after surgery.

A certain technique used during surgery seemed to help protect against MH, but the results weren’t statistically significant, meaning they could have been due to chance.

Treatment options for MH after surgery included observation, injecting gas into the eye, or another surgical procedure. The hole closed in 83% of the treated eyes. The success rate was 67% for observation, 71% for gas injection, and 91% for surgery. But unfortunately, the vision outcomes were worse for eyes with postoperative MH than those without.

In simple terms, 12% of patients who had surgery for a nearsightedness-related vision problem developed a new eye problem, and while most were able to get it treated, their vision didn’t improve as much as those who didn’t develop the new problem.

FAQs

  1. What is the likelihood of developing a macular hole (MH) after surgery for myopic traction maculopathy (MTM)?
  2. What are the risk factors for developing a MH after surgery for MTM?
  3. What are the treatment options for a MH that occurs after surgery, and how successful are they?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vitrectomy is to be aware of the potential risk of developing a macular hole after surgery, especially if they are male, have a thinner choroid, or had a specific dye used during the procedure. It’s important to follow up with their doctor regularly and report any changes in vision promptly. If a macular hole does develop, there are treatment options available, but the success rates may vary. It’s essential to discuss any concerns or questions with their healthcare provider to ensure the best outcome possible.

Suitable For

Patients who are typically recommended vitrectomy include those with conditions such as retinal detachment, macular hole, epiretinal membrane, diabetic retinopathy, vitreous hemorrhage, and certain types of eye infections or injuries. These patients may experience symptoms such as vision loss, floaters, flashes of light, or distorted vision, and may benefit from the removal of the vitreous gel in the eye to improve their vision and prevent further complications. It is important for patients to consult with their ophthalmologist to determine if vitrectomy is the right treatment option for their specific condition.

Timeline

Before vitrectomy:

  • Patient experiences vision problems related to nearsightedness, such as myopic traction maculopathy (MTM)
  • Patient undergoes surgical procedure to treat vision problem
  • Risk factors such as being male, having a thinner choroid, and using a specific dye during surgery may increase the likelihood of developing a macular hole (MH) after surgery

After vitrectomy:

  • 12% of patients develop a MH after surgery
  • Treatment options for MH include observation, gas injection, or another surgical procedure
  • The success rate for closing the hole is highest with surgery (91%)
  • However, vision outcomes for eyes with postoperative MH are worse compared to those without the new problem

What to Ask Your Doctor

Some questions a patient should ask their doctor about vitrectomy include:

  1. What are the potential risks and complications associated with vitrectomy surgery?
  2. Am I at a higher risk for developing a macular hole after the surgery?
  3. How will you monitor me for the development of a macular hole post-surgery?
  4. What are the treatment options available if I do develop a macular hole?
  5. What are the success rates of different treatment options for a macular hole post-surgery?
  6. How will the development of a macular hole affect my vision outcomes after surgery?
  7. Are there any specific factors about my eye health that may increase my risk for developing a macular hole post-surgery?
  8. Are there any steps I can take to potentially reduce my risk for developing a macular hole after surgery?

Reference

Authors: Wakabayashi T, Shiraki N, Tsuboi K, Oshima Y, Abe K, Yamamoto Y, Hisashi F, Baba K, Ishida Y, Otsuka Y, Shiraki A, Suzue M, Hashimoto R, Venkatesh R, Chhablani J, Gomi F, Kamei M, Maeno T, Regillo CD, Yonekawa Y, Ikuno Y; SCHISIS Study Group. Journal: Ophthalmol Retina. 2023 Sep;7(9):779-787. doi: 10.1016/j.oret.2023.05.017. Epub 2023 May 29. PMID: 37257585