Purpose: As reported anatomic success rates for macular hole surgery increase, a method of accurately predicting postoperative visual acuity has increased clinical utility. Methods: A series of 18 patients undergoing vitrectomy for idiopathic macular holes was evaluated prospectively for best refracted preoperative visual acuity, potential acuity meter (PAM) reading, and laser interferometer (LI) reading. Best refracted visual acuity after surgery was recorded and analyzed to assess the predictive value of the PAM and LI readings. Results: The LI correctly predicted the final visual result in 6 of the 10 patients who achieved a final visual acuity of 20/50 or better (P = <0.011). The PAM did not accurately predict postoperative visual acuity for any of the eyes with a final visual acuity of 20/50 or better. Both correctly predicted outcome in the 7 patients with final visual acuity worse than 20/50. The LI prediction was within 2 lines of final visual acuity in 12 (70%) of 17 anatomically successful cases, and the PAM was within 2 lines of final visual acuity in 11 (64%) of 17 cases. Conclusion: Both the LI and PAM were modestly accurate in predicting final visual acuity after macular hole surgery, but the LI was more accurate in predicting a visual acuity of 20/50 or better.
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