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Visual function and subjective perception of visual ability after macular hole surgery.

Paris G Tranos·Seyed M S Ghazi-Nouri·Gary S Rubin·Zoe C Adams·David G Charteris
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Abstract

PURPOSE: To evaluate the functional and anatomical results of macular hole surgery and to explore its effect on patients' Health-Related Quality Of Life (HR-QOL) and to investigate the associations between self-reported HR-QOL and conventional measures of visual function. DESIGN: Case series. METHODS: The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and the 36-Item Short-Form Health Survey (SF-36) were self-administered by 30 patients before and 4 months after macular hole surgery. Preoperative, intraoperative, and postoperative clinical data were collected including visual acuity, contrast sensitivity, and metamorphopsia. Multi-item scales rating different aspects of HR-QOL were compared before and after surgery, and their correlation with traditional methods of outcome evaluation was analyzed. RESULTS: Macular hole closure was achieved in 26 patients (87%). Mean LogMAR visual acuity improved by 6 +/- 10 letters for distance and 7 +/- 12 letters for near. Metamorphopsia was reduced by a mean of 35 +/- 70 squares on Amsler chart, and Pelli-Robson contrast sensitivity decreased by a mean of -0.09 +/- 0.3 log units postoperatively. The VFQ-25 composite score as well as scale scores associated with general vision, near vision, vision-related mental health, and role difficulties were significantly improved (P < .05) after successful closure of macular hole. Conversely out of the eight SF-36 health concepts, limitation in usual role activities because of emotional problems was the only one that significantly improved postoperatively. Both baseline and postoperative best-corrected visual acuity significantly correlated with most of the VFQ subscale scores before and after surgery, respectively. CONCLUSIONS: In this case-series, macular hole surgery appears to have a beneficial effect on patients' subjective perception of visual function. The use of vision-targeted health status questionnaires in conjunction with detailed clinical examination provides a more comprehensive overview of individuals' daily well-being after surgical intervention. Further controlled studies are required to confirm our findings.

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AgedAged, 80 and overContrast SensitivityFemaleHealth StatusHumansIntraoperative ComplicationsMaleMiddle AgedOphthalmologic Surgical ProceduresPostoperative ComplicationsProspective StudiesQuality of LifeRetinal PerforationsSickness Impact ProfileSurveys and QuestionnairesVisual AcuityJournal Article

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Paris G Tranos, Seyed M S Ghazi-Nouri, Gary S Rubin, Zoe C Adams, David G Charteris. 2004. Visual function and subjective perception of visual ability after macular hole surgery.. https://doi.org/10.1016/j.ajo.2004.07.049

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