Abstract:  Objective To analyze the factors associated with visual prognosis of pars plana vitrectomy (PPV) combined with membrane insertion for unclosed macular hole (MH) after internal limiting membrane peeling. Design Retrospective case series. Participants Twenty-seven eyes of 27 patients with unclosed MH after internal limiting membrane peeling who were treated in Beijing Tongren Hospital from January 2018 to November 2020. Methods The date about age, best corrected visual acuity (BCVA), intraocular pressure, axial length, morphological classification of MH, OCT measuring parameters, interval between two operations, material of insertion and BCVA at last follow-up were collected. The follow-up time was(12.07±8.65) months (1-36 months). Risk factors of BCVA (LogMAR) more than 0.70 at last follow-up was analyzed by univariate and multivariate Logistic regression analysis. Main Outcome Measures BCVA at last follow-up and its possible risk factors. Results Univariate Logistic regression analysis revealed that morphology of MH before operation (OR=14.667, 95% CI 1.970-109.204, P=0.009) and interval between two operations (OR=9.625, 95% CI 1.378-67.246, P=0.022) were associated with BCVA at last follow-up. Multivariate Logistic regression analysis showed that elevated MH  (OR=20.230, 95% CI 1.640-249.561, P=0.019) and interval between two operations longer than 2 months  (OR=13.899, 95% CI 1.072-180.278, P=0.044) increases the chances of BCVA more than 0.70 at last follow-up. Conclusion Elevated MH and interval between two operations longer than 2 months were the risk factors of poor postoperative BCVA after PPV combined with membrane insertion for unclosed MH after internal limiting membrane peeling. （Ophthalmol CHN, 2022, 31: 135-139）

Key words: macular hole, internal limiting membrane, reoperation, risk factors