Yi Fan Tang1, Andrew Chang2, William Campbell3, Paul Connell4, Alex Hunyor2, Ian McAllister5, Rohan Essex1,3,6

Purpose: To report the outcomes of eyes receiving surgical management for traumatic macular holes. To describe the pre and postoperative optical coher- ence tomography (OCT) features of traumatic macu- lar holes and to explore associations between clinical and OCT features, and visual outcome.
Methods: Prospective registry-based study of patients undergoing vitrectomy for traumatic macu- lar hole. Preoperative clinical data, surgical details, and 3-month postoperative outcomes were recorded by surgeons contributing to the Australian and New Zealand Society of Retinal Specialists registry. Longer-term outcomes at 12 months were requested retrospectively, as were pre and postoperative OCT scans.
Results: Hole closure was achieved in 91% (21/23) of patients with a single procedure. The average pre- operative visual acuity (VA) was 20/120. At
3 months post-operatively the mean VA had improved to 20/70 (P < 0.001), 11/23 (48%) of eyes improved ≥15 letters and the number of eyes with 20/40 acuity or better increased from 1/23 to 7/23. Eyes with worse visual outcomes (VA < 20/80) had larger holes, worse preoperative acuity and a greater extent of preoperative ellipsoid band attenuation than those with better postoperative VA. Conclusions: Eyes receiving surgical management for traumatic macular hole achieved good anatomical and visual results. Ellipsoid band attenuation on preoperative OCT, larger holes and worse preopera- tive acuity were associated with poorer visual outcomes.