Preoperative Predictors of Visual Acuity Improvement Following Macular Hole Surgery in Pseudophakic Eyes

Purpose: This study explored preoperative factors associated with visual acuity improvement following surgery for idiopathic macular hole in pseudophakic eyes.Methods: To eliminate the confounding effects of cataracts, only cases with successful macular hole closure after surgery in pseudophakic eyes were included. In total, 64 eyes from 64 patients who underwent surgery between January 2013 and December 2022 were retrospectively analyzed. Patients who demonstrated an improvement of at least two lines on the visual acuity chart within 6 months postoperatively were categorized as Group A, whereas others were included in Group B for comparison.Results: At 6 months postoperatively, 39 eyes showed an improvement of two or more lines in visual acuity and were assigned to Group A, while the remaining 25 eyes were included in Group B. Significant differences between the two groups were observed in sex distribution (p = 0.042), preoperative external limiting membrane (ELM) defect length (p = 0.018), and the presence of perifoveal cysts (p = 0.030). Quantitative analysis of optical coherence tomography findings revealed a preoperative ELM defect length threshold of 1,023.50 μm, although the sensitivity (0.672) and specificity (0.600) of this parameter were relatively low.Conclusions: Postoperative visual acuity improvement was more likely in patients who were male, had preoperative perifoveal cysts, or exhibited shorter ELM defect lengths.