Changes in visual acuity and retinal microstructures following vitrectomy for lamellar macular hole

This study aimed to evaluate the changes in visual outcomes and optical coherence tomography (OCT) findings in patients with lamellar macular hole (LMH) following vitrectomy. Consecutive patients diagnosed with LMH based on OCT findings who underwent vitrectomy between April 2020 and December 2023 were included. Forty-two patients (male, n = 21; female, n = 21; mean age, 71.3 ± 8.2 years) were included in the study. Preoperative and postoperative best-corrected visual acuity (BCVA) and OCT parameters, including the presence of inner and outer retinal cysts, epiretinal proliferation (EP), and ellipsoid zone disruption (EZ), were analyzed. Postoperative BCVA was assessed at 6 months after surgery, and postoperative OCT findings were evaluated at 1, 3, and 6 months using all available data. Mean BCVA significantly improved from 0.36 ± 0.33 logarithm of the minimal angle of resolution preoperatively to 0.15 ± 0.26 at 6 months postoperatively (p < 0.001). The frequency of eyes with inner retinal cysts was 21.4% preoperatively, which gradually decreased to 8.0% at 6 months postoperatively. The frequency of outer retinal cysts was 54.8% preoperatively, which significantly decreased to 12.0% at 6 months postoperatively (p = 0.00937). The presence of EP was significantly correlated with worse postoperative BCVA (p < 0.05). Both preoperative and postoperative EZ disruptions significantly correlated with worse postoperative BCVA (p < 0.05). Vitrectomy for LMH improves visual acuity and reduces most intraretinal cysts within 6 months. EP, EZ disruption, and poor preoperative visual acuity were identified as factors associated with poor visual outcomes in patients with LMH.