Ability to determine postoperative status of macular hole in gas-filled eyes by spectral-domain optical coherence tomography.

Background:  To determine whether the status of a macular hole can be determined by spectral-domain optical coherence tomography in gas-filled eyes. Design:  Prospective study, university hospital setting. Participants:  Twenty-six eyes with a macular hole, seven eyes with a macular hole retinal detachment and four eyes with a macular hole and myopic traction maculopathy underwent vitreous surgery. Methods:  The macular area was examined by spectral-domain optical coherence tomography (OCT-4000) on postoperative days 1, 3, 7 and 30. Main Outcome Measures:  Detection of macular hole closure. Results:  The status of macular hole was able to be assessed in 24 eyes (92%) on postoperative day 1 and 23 were closed. The condition of the macular hole could not be determined in the other two eyes with a lower volume of gas (≤60%). The macular hole of seven eyes could be seen only when the patients looked upward or downward (P = 0.009). The 11 eyes with a macular hole retinal detachment or a myopic traction maculopathy had a posterior staphyloma, and the macular hole was visible in four eyes on day 1 (P = 0.001). When a closure of the macular hole was detected on day 1, the macular hole remained closed in all of these eyes on day 30. Conclusions:  The status of a macular hole can be determined by spectral-domain optical coherence tomography on postoperative day 1 even in gas-filled eyes. The visibility depends on the volume of intravitreal gas and the absence of a posterior staphyloma.