Visual function and vision-related quality of life after macular hole surgery with short-duration, 3-day face-down positioning

OBJECTIVE: To investigate the relationship of vision-related quality of life (VRQOL) and visual function in patients undergoing macular-hole (MH) repair with and without cataract surgery and short-duration, 3-day prone posturing. Previous communications have assessed VRQOL in European and Japanese populations, but this is the first study to investigate VRQOL after MH surgery in a Canadian population. DESIGN: Prospective interventional case series. PARTICIPANTS: We studied 20 consecutive eyes in 19 patients with stage 2 and 3 idiopathic macular holes. Of those, 15 received combined cataract and MH surgery, and 5 received MH repair alone. METHODS: Patients completed the self-administered National Eye Institute 25-item Visual Function Questionnaire before and after surgery. All patients received full ocular examinations pre- and postsurgery. Along with the questionnaire scores, we examined macular-hole closure rates, complications, postoperative visual acuity, and intraocular pressure. RESULTS: Macular-hole closure was achieved in 20 of 20 eyes (100%). Mean postoperative logMAR decreased (i.e., improved) by -0.303 (95% CI, -0.501-- -0.105, p = 0.0047). The Visual Function Questionnaire composite score rose from 82.019 ± 12.612 SD to 88.499 ± 7.963 SD (p = 0.012). Subscale scores, including general vision, near activities, mental health, role difficulties, and dependency were all significantly improved (p < 0.05). No complications or intraocular pressure increases were observed. CONCLUSIONS: Macular-hole surgery followed by short-duration, 3-day face-down positioning significantly improved VRQOL and visual acuity in a group of Canadian patients. The use of VRQOL tools alongside anatomic outcomes provide a more comprehensive overview of patients' experiences and satisfaction after surgical intervention.