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The effect of ethnicity on anatomic success following macular hole surgery: a multicentre cohort study

Lookup NU author(s): Dr Teresa Sandinha, Professor David SteelORCiD


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© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: The purpose is to assess the effect of ethnicity on surgical macular hole closure. Methods: A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/oil tamponade for all stages of primary full-thickness macular hole (FTMH). The primary outcome was anatomic success, defined as FTMH closure with one operation. The secondary outcome was mean change in best-corrected visual acuity (BCVA) comparing baseline with final review. Results: Of 334 operations, the ethnicity profile comprised 78.7% White patients, 11.7% Black patients, 8.1% Asian patients, and 1.5% in mixed/other ethnicities. Mean age was 69.7 years with 68.5% females. Overall, 280 (83.8%) had anatomic success. Anatomic failure occurred in 38.5% of Black patients versus 12.6% of White patients (relative risk: 1.788; 95% CI: 1.012 to 3.159; P = 0.045). Overall, baseline logarithm of the minimum angle of resolution BCVA improved by 0.34, from 0.95 (95% CI: 0.894 to 1.008) to 0.62 (95% CI: 0.556 to 0.676). Mean BCVA improved by 0.35 in White patients, 0.37 in Black patients, 0.23 in Asian patients, and 0.38 in mixed/other ethnicity (P = 0.689). Greater FTMH minimum linear diameter was associated with an increased risk of anatomic failure (relative risk: 1.004; 95% CI: 1.002 to 1.005; P < 0.0001), whereas better pre-operative BCVA (F [1,19] = 162.90; P < 0.0001) and anatomic success (F [1,19] = 97.69; P < 0.0001) were associated with greater BCVA improvement. Socio-economic status did not significantly influence anatomic success or BCVA change. Conclusions: Black ethnicity is associated with an approximately twofold greater risk of failed FTMH surgery. The reasons for this difference warrant further study. [Figure not available: see fulltext.].

Publication metadata

Author(s): Laviers H, Papavasileiou E, Bruce C, Maubon L, Radia M, Dervenis N, Zuckerman B, Loh GK, Theodorou O, Douiri A, Zambarakji H, Sandinha T, Steel DH, Kirthi V, McKechnie C, Zakir R, Duguid G, Jackson TL

Publication type: Article

Publication status: Published

Journal: Graefe's Archive for Clinical and Experimental Ophthalmology

Year: 2023

Volume: 261

Pages: 1535-1543

Online publication date: 05/01/2023

Acceptance date: 20/12/2022

ISSN (print): 0721-832X

ISSN (electronic): 1435-702X

Publisher: Springer Nature


DOI: 10.1007/s00417-022-05950-w

PubMed id: 36602644


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