Anatomical and functional outcomes of vitrectomy combined with conventional internal limiting membrane peeling in macular hole patients treated at our clinic

Objective: The purpose of this study was to evaluate the anatomical and functional outcomes in patients who underwent surgery for idiopathic full-thickness macular hole (IFTMH) in our clinic and to identify the prognostic factors affecting surgical success. Methods: The records of 62 patients (62 eyes) who underwent pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling at Harran University Faculty of Medicine, Department of Ophthalmology, between January 2020 and December 2024 were retrospectively reviewed. Anatomical success was defined as macular hole closure. Functional improvement was defined as a decrease (improvement) of at least 0.2 logMAR in best-corrected visual acuity (BCVA), and functional success was defined as a 6-month postoperative BCVA of ≤ 0.3 logMAR. Demographic, clinical, and optical coherence tomography (OCT)-based morphometric parameters affecting success were statistically analyzed. Results: The postoperative anatomical success rate was found to be 83.9% (n=52). Anatomical success was significantly associated with female gender (p=0.001), earlier stage (p=0.002), and postoperative ellipsoid zone (EZ) integrity (p=0.002). A smaller minimum hole diameter was a significant predictor for anatomical success (p=0.020). Functional improvement was observed in 71% (n=44) of patients, while functional success was achieved in 14.5% (n=9). A short duration of symptoms was the factor most strongly associated with both functional improvement (p=0.017) and functional success (p=0.001). Functional success was also associated with better preoperative BCVA (p=0.001), earlier stage (p=0.013), preserved EZ integrity (p=0.004), and a more favorable hole morphology on OCT (smaller diameters, higher MHI, THİ, HFF). Conclusion: Surgery for IFTMH is an effective treatment with high anatomical success rates. Early diagnosis and timely intervention significantly improve functional outcomes. Preoperative BCVA, duration of symptoms, hole stage, and OCT-based morphometric parameters are important guides for predicting surgical success.