INFLUENCE OF FOVEAL GLIAL TISSUE AFTER MACULAR HOLE SURGERY ON OUTER RETINAL RESTORATION AND VISUAL ACUITY

Purpose: To investigate the impact of foveal glial tissue on the anatomical and functional results after macular hole (MH) surgery. Methods: This study included 141 consecutive eyes that underwent successful vitrectomy for full-thickness MH between January 2015 and December 2022. The best-corrected visual acuity and the length of outer retinal defects were evaluated preoperatively and at 6 months postoperatively. Macular hole with retinal detachment, recurrent MH, and traumatic MH were excluded. Multiple regression analyses were conducted on outer retinal restoration and visual acuity using foveal glial tissue size, surgical technique of internal limiting membrane peeling or inverted internal limiting membrane flap, and high myopia as explanatory variables. Results: Analyses revealed that the foveal glial tissue significantly limited the outer nuclear layer, external limiting membrane restoration, and ellipsoid zone restoration as well as best-corrected visual acuity improvement (r = -0.380, P < 0.001; r = -0.314, P = 0.035; r = -0.530, P = 0.015; r = -0.00027, P = 0.001; respectively). Meanwhile, the surgical technique and high myopia did not significantly affect the restoration of outer nuclear layer, external limiting membrane, ellipsoid zone, and best-corrected visual acuity after surgery. Conclusion: Foveal glial tissue after MH surgery attenuated outer nuclear layer, external limiting membrane, and ellipsoid zone restoration as well as best-corrected visual acuity improvement.