Relative Factors Analysis Of Visual Acuity Of Patients With Macular Hole After Phaco-vitrectomy

PURPOSE: To evaluate the best-corrected visual acuity and parameters after the combined phaco-vitrectomy for macular hole surgery in idiopathic macular hole,high myopicmacular hole with retinal detachment and non-retinal detachment.METHODS:43 cases of patients in Tianjin Ophthalmological Hospital from January 2015 to December 2015,which contains 25 cases of idiopathic macular hole,9 cases of high myopic macular hole with retinal detachment and 9 cases of high myopia macular hole without retinal detachment.All of patients treated by the phaco-vitrectomy surgery.Baseline and after-operation in two weeks,one month,three months,six months examination including basic situation of patient,best corrected visual acuity(BCVA),intraocular pressure(IOP),slit lamp microscope,binocular indirect ophthalmoscope and spectral-domain optical frequency domain(SD-OCT)and so on.RESULTS: External limiting membrane morphological changes in three types of surgery,25 cases were all visible membrane healing,92% from the ELM healed in 3-6 months,the ELM healing time was negatively correlated(r=-0.4047.P=0.0448)preoperative visual acuity,the mean preoperative visual acuity was 0.16±0.12,6m after the operation,the average visual acuity was 0.63±0.22.Ocular axis were negatively correlated with the visual acuity(r=0.0482),preoperative axial and postoperative after 2w,1m,3m,6m were statistically significant(P<0.0001),the axial was not statistically significant after 2w,1m,3m and 6m.The average visual acuity was 0.13±0.09,6m average postoperative visual acuity of 0.39±0.29,ocular axis and each time point of visual acuity(p=0.6718),there was no correlation between preoperative and postoperative ocular axis.Preoperative visual acuity is ELM healing protective factors(χ~2 =16.49 P<0.0001).High myopic macular hole without retinal detachment of the average preoperative visual acuity of 0.05±0.07,6m average postoperative visual acuity of 0.42±0.26,age is a risk factor for external membrane healing(χ~2 =8.35 p=0.0038),preoperative visual acuity was the protective factor of external membrane healing(χ~2 =4.12 p=0.0425).The change of axial length at different time points were statistically significant.CONCLUSIONS:1 The changes of retinal morphological is closely related to the visual function.The better of preoperative visual acuity,the sooner of ELM healing always occurred in 3-6 months.Age is a risk factor for ELM and preoperative visual acuity is a protective factor for ELM healing.2 The change of the ocular axis is related to the vision,the shorter of the eye axis,the better of the vision.However,the change of the morphological macular retinal and eccentric gaze which lead to the changes of ocular axis.