Improvement in visual acuity following cataract extraction after successful macular hole surgery

Purpose. Progression of postvitrectomy associated nuclear sclerosis may offset some of the visual gain following successful macular hole surgery (MHS). In this circumstance cataract extraction (CE) is generally felt to be indicated however there have been no reports of the subsequent visual outcome in a large series of patients. The purpose of this study was to evaluate visual improvement following CE after successful MHS. Methods. Analysis of 97 consecutive eyes undergoing CE following successful MHS was performed. All data was collected prospectively, including best-corrected visual acuity measured with a logarithmic eye chart (ETDRS) in a standardized fashion. Results. Mean acuity prior to MHS was 20/100+2 (20/32-1 to <20/200). Mean acuity 3 months following MHS was 20/63 (20/25-1 to <20/200). The mean time to CE following MHS was 282 days (111 to 572). Mean pre-CE acuity was 20/63-2 (20/25-2 to <20/200). Mean post-CE acuity was 20/40-2 (20/20 to 20/160-2); 13 (13.4%), 18 (18.6%), and 20 (20.6%) eyes had ≥ 4 lines, 3-4 lines, and 2-3 lines of improvement in acuity following CE respectively. Worsening of acuity of ≥ 1 line occurred in 6 (6.2%) eyes and was associated with cystoid macular edema or capsular opacification. Conclusions. Cataract extraction following successful macular hole surgery usually results in improvement of central acuity although a small percentage of eyes may experience visual loss.