Korean J Ophthalmol.  2006 Jun;20(2):93-98. 10.3341/kjo.2006.20.2.93.

Laser Photocoagulation as Adjuvant Therapy to Surgery for Large Macular Holes

• Cho HY
• Kim YT
• Kang SW

• KMID: 1099042
• DOI: http://doi.org/10.3341/kjo.2006.20.2.93

Abstract

PURPOSE: To evaluate the effectiveness of laser photocoagulation as adjuvant therapy in the treatment of large macular holes. METHODS: A randomized clinical trial. Thirty-one eyes from 29 subjects with idiopathic macular holes of diameters larger than 400 micrometer were randomized into a laser group and a control group. All eyes underwent vitrectomy with peeling of the internal limiting membrane. Contrary to the control group eyes, the laser group eyes underwent laser photocoagulation at the center of the macular hole before vitrectomy. Visual acuity and anatomic outcomes assessed by optical coherence tomography (OCT) were analyzed 3 months after surgery. RESULTS: On postoperative OCT, closure of the macular hole was noted in 17 of the 18 (94.4%) laser group eyes and 10 of the 13 (76.9%) control group eyes. Hole closure without bare retinal pigment epithelium was observed in 16 eyes in the laser group and 6 eyes in the control group (P<0.05). The amount of improvement in logMAR visual acuity 3 months after surgery was 0.40+/-0.29 in the laser group, and 0.19+/-0.23 in the control group (P<0.05). CONCLUSIONS: Laser photocoagulation constitutes a potent adjuvant therapy that may improve anatomical and visual outcomes of surgery for macular holes larger than 400 micrometer.

Keyword

Laser photocoagulation; Macular hole; Optical coherence tomography

MeSH Terms

*Vitrectomy
Visual Acuity
Treatment Outcome
Tomography, Optical Coherence
Time Factors
Severity of Illness Index
Retrospective Studies
Retinal Perforations/pathology/*surgery
Middle Aged
Male
Macula Lutea/pathology/surgery
*Laser Coagulation
Humans
Follow-Up Studies
Female
Aged

Figure

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  Fig. 1 Postoperative funduscopic findings of a patient with bilateral macular holes. The preoperative hole diameter of the right and left eyes was 689.5 µm and 711.5 µm, respectively. The left eye, which was randomized into the laser group, showed type 1 closure 3 months after surgery (A). In contrast, the right eye in the control group had type 2 closure (B).

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  Fig. 2 Scatterplot distribution of preoperative versus postoperative Snellen visual acuity of all study eyes. The diagonal line represents no change in visual acuity.

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