Operculum in idiopathic macular holes

PURPOSE: To detect the factors related to the operculum in idiopathic macular holes and present a pathogenesis of idiopathic macular holes. METHODS: This study included 583 eyes of idiopathic macular hole that underwent macular hole surgery. To detect the factor related to the operculum, the variables of age, duration of symptoms, hole size, preoperative visual acuity, refraction, axial length, refraction axial length ratio were used for the comparison between two groups and multiple regression. The success rate of surgery and postoperative visual acuity were examined whether the operculum was present or not. RESULTS: The variables that were significantly related to the operculum were as follows: refraction axial length ratio (r = 0.18, p = 0.0092) in women of stage 3, duration of symptoms (r = -0.44, p < 0.001), preoperative visual acuity (r = -0.33, p = 0.0025), and refraction axial length ratio (r = -0.22, p = 0.020) in women of stage 4, and age (r = 0.19, p = 0.047) in men of stage 3. There were no significant differences in the success rate of surgery and postoperative visual acuity whether the operculum was present or not. CONCLUSIONS: Generally, operculum tends to occur in aged and round eyes and possibly does not occur in younger and back projected eyes because of retinal fissure. In women of stage 4, the operculum is possibly a torn retina and does not occur in atrophic holes.