Advantages:

To analyze the morphologic changes (based on Optical Coherence Tomography: OCT examination) and the functional changes (based on determination of Best Corrected Visual Acuity: BCVA) in patients with the diagnosis of idiopathic partial-thickness macular holes (idiopathic Lamellar Macular Hole: LMH or Macular Pseudohole: MPH) who underwent routine cataract surgery.

Methods:

We prospectively analyzed 25 eyes of 23 patients with the diagnosis of idiopathic LMH or MPH on OCT (Cirrus SD, Dublin, Germany) examination, who underwent uneventful phacoemulsification due to the presence of cataract. The OCT-based diagnostic criteria for LMH were the following: Irregular thinning of foveal base, break in the inner fovea, intraretinal split (dehiscence of the inner foveal retina from the outer retina), normal perifoveal retinal thickness and absence of a full thickness foveal defect. The diagnostic criteria for MPH were partial thickness macular defect, normal central retinal thickness despite the loss of inner layers (explained by an increase in perifoveal thickness), a steepened defect, with verticalized foveal slopes, due to the contraction of an ERM, visible in OCT scans. Best Corrected Visual Acuity (BCVA) (LogMAR notation), biomicroscopic examination, fundus photography, size of the defects (diameter -D-, Residual Thickness -RT- and Nasal and Temporal Perifoveal Thickness: NPT, TPT) measured by OCT (microns), were recorded in all patients, before and after surgery.

Effectiveness / Safety:

Mean BCVA (LogMAR) in the total group at baseline was 0.46 ± 0.25 (0.00 – 1.30), and at final examination was 0.18 ±0.14 (0.00 – 0.50), being these differences statistically significant (p=0.000). We did not observe statistically significant differences regarding any of the anatomic parameters (D, RT, NPT, TPT) between the onset and the end of the study, in the total group (p=0.626, p=0.377, p=0.571, p=0.440, respectively) and also in the subgroups of LMH and MPH (p>0.05).

Conclusion:

Most of idiopathic LMH and MPH do not progress anatomically (based on OCT) after uncomplicated phacoemulsification, during the follow-up period. Furthermore, a significant improvement in best-corrected visual acuity can be achieved after cataract extraction in patients with LMH and MPH, and this must be taken into account before considering vitreoretinal surgery in these patients.