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목적 : To identify the risk factors of a secondary macular hole (MH) developing after vitrectomy and assess treatment outcomes.
방법 : Patients that developed a postoperative secondary MH were identified among those who underwent vitrectomy at two tertiary hospitals between January 2006 and December 2016 and were retrospectively reviewed. The primary outcome was the clinical characteristics associated with the development of a secondary macular hole, such as the primary diagnosis for initial surgery and features on multimodal imaging. Secondary outcomes included final best-corrected visual acuity (BCVA, logMAR), the clinical factors associated with the visual prognosis and rate of requirement of multiple operations.
결과 : Thirty-eight eyes (mean age: 57.1±14.6yrs) were identified out of 6354 cases (incidence 0.6%). The most frequent primary diagnoses for initial vitrectomy were retinal detachment (9 eyes, 5 macula-off) and secondary epiretinal membrane (6 eyes). Surgery for closure of secondary MH was performed in 36 eyes (94.7%), with closure achieved in 34. A 3-line visual gain was noted in 18 cases (50%). Onset BCVA (OR=0.056, P=0.036), BCVA at postoperative month 3 (OR=52.671, P=0.011), and axial length ≥28 mm (OR=28.487, P=0.030) significantly influenced a 3-line visual loss.
결론 : Secondary MH occurs rarely after vitrectomy and can be successfully treated in most cases. Patients with axial length ≥28 mm and poor BCVA at 3 months post-operation may have limited visual prognosis and those with a history of macula-off RD may require multiple surgeries.
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