Purpose: In this study, the authors apply objective measures of bilateral visual function to investigate the benefits of macular hole surgery to overall visual function. Methods: Anatomic and visual acuity outcomes were reviewed for patients undergoing primary macular hole surgery at one institution during a 3-year period. Several measures of bilateral visual function were defined to determine the impact of surgery on bilateral visual function. Patient data were analyzed in two separate cohorts based on whether the fellow eye was normal (visual acuity ≥ 20/40, fellow eye normal group) or abnormal (visual acuity < 20/40, fellow eye abnormal group) at baseline to determine the effect on visual function improvement. Results: The rim of subretinal fluid resolved after surgery in 85% of patients and 82% gained two or more Early Treatment Diabetic Retinopathy Study lines of visual acuity. After surgery, visual acuity in the surgical eye was better than or equal to the fellow eye in 35%, and average visual impairment according to the American Medical Association Guidelines for Disability decreased from 29% to 17%. Among the FEA group, vision in the surgical eye was better than or to equal to that of the fellow eye in 70%, and visual impairment was reduced from 52% to 35%. Conclusion: Bilateral visual function was improved after macular hole surgery. The improvement rate was markedly better in patients with subnormal vision in the fellow eye.
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