Macular changes after uncomplicated phacoemulsification surgery in patients with idiopathic partial-thickness foveal defects

Resumen

PURPOSE: 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 partialthickness foveal defects (Lamellar Macular Hole —LMH— or Macular Pseudohole — MPH—) who underwent routine cataract surgery. SETTING: Hospital Universitario Central de Asturias and Instituto Oftalmológico Fernández-Vega, Oviedo, Spain. METHODS: We prospectively analyzed 25 eyes of 23 patients with idiopathic LMH or MPH on OCT examination, who underwent uneventful phacoemulsification due to the presence of cataract. BCVA (logMAR notation), biomicroscopic examination, fundus photography, size of the defects (Diameter, Residual Thickness, and Nasal and Temporal Perifoveal Thickness) measured by OCT, were recorded in all patients, before and after surgery. RESULTS: Mean BCVA 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), this difference being statistically significant (p<0.001). We did not observe statistically significant differences regarding any of the anatomic parameters 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 neither in the subgroups of LMH and MPH (p>0.05). CONCLUSIONS: Most of idiopathic LMH and MPH did not progress anatomically (based on OCT) after uncomplicated phacoemulsification, during the follow-up period. Furthermore, a significant improvement in BCVA can be achieved after cataract surgery in patients with LMH and MPH, and this must be taken into account before considering vitreoretinal surgery in these patients.