Abstract
Background: To evaluate the vision-related quality of life of vitrectomy combined with autologous internal limiting membrane(ILM) transplantation for refractory macular hole. Methods: A prospective and nonrandomized clinical study was carried out. There were fourty eyes with refractory macular hole included and all eyes received 23G vitrectomy and ILM peeling with autologous ILM transplantation. Preoperative and postoperative basic conditions were recorded, including best corrected visual acuity (BCVA), intraocular pressure, central retinal thickness (CRT) measurement by Optical coherence tomography (OCT) examination, macular hole index (MHI) and operative complications. The Chinese version of visual-related quality of life scale -25 (CVRQoL-25) was used to evaluate the visual related quality of life of patients after operation. The correlation between the quality of life and the postoperative visual acuity and the size of the macular hole before operation was tested by Spearman rank correlation test. Results: All patients were followed up for three months after surgery, and 38 patients achieved anatomical closure. The mean postoperative logMAR BCVA was 1.09±0.33, which has significantly improved than that before operation (P=0.000). The vision-related quality of life of patients after surgery was closely related to the macular hole index (r=0.375, P=0.017), but was negatively correlated with the best corrected visual acuity before and after surgery (r=-0.495, P=0.001; r=-0.760,P=0.000). It was also found that the vision-related quality of life of patients positively correlated with the postoperative CRT ( r=0.414,P=0.008). Conclusions: The anatomical structure of refractory macular hole patients with ILM peeling combined with autologous ILM transplantation was largely reduced, and the visual acuity of the patients improved significantly. Meanwhile, the vision-related quality of life was significantly improved after surgery. Trial Registration: ChiCTR-INR-16008660, date of registration: 2016/06/17