Abstract / Summary
Abstract Purpose To quantify the incidence of unplanned return to the operating room (OR) within 12 months following primary macular hole repair and to pinpoint the key preoperative and intraoperative factors associated with persistent or recurrent macular holes. Methods This retrospective observational study included patients undergoing primary macular hole repair surgery with ≥ 12 months of follow-up. Eyes requiring reoperation due to non-closure or reopening of the macular hole were defined as the case group, and those not requiring reoperation as the control group. The incidence of unplanned reoperation was calculated, and multivariable logistic regression was performed to evaluate potential risk factors for unplanned reoperation. Results Among 1624 eyes, 6.5% (106 eyes) had an unplanned return to the OR. And the most common reason was persistent or recurrent macular hole in 94 eyes (88.7%, 94/106), which required another macular hole repair surgery in 28.0 (14.0–59.5) days. In the multivariable model, two factors were associated with significantly elevated odds of unplanned reoperation: macular hole size > 400 μm (odds ratio, 6.77; 95% confidence interval [CI], 1.44–31.79) and autologous blood covering (odds ratio, 2.30; 95% CI, 1.12–4.74). In contrast, the use of autologous internal limiting membrane (ILM) flap techniques was associated with lower odds of unplanned reoperation (odds ratio, 0.30; 95% CI, 0.15–0.58). Conclusions Patients with macular hole size > 400 μm and those receiving autologous blood covering were associated with higher odds of unplanned reoperation, the latter likely reflecting its preferential use in more complex, larger macular holes. Conversely, the use of autologous ILM flap techniques was associated with lower odds of unplanned reoperation.