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Peer-reviewedCC BY 4.0PLOS One

Visual and anatomical outcomes of full-thickness macular hole surgery and associated factors in selected hospitals in Tanzania

  • Heavenlight Estomihi Masuki1
  • Jovin S. Sagale2
  • Celina F. Mhina3
  • Mustafa Yusufali
  • William Makupa
  • Milka Mafwiri
  1. 1Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  2. 2Department of Ophthalmology, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Hospital, Dar es Salaam, Tanzania
  3. 3Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Abstract

Purpose: To determine the anatomical and visual outcomes of macular hole surgery and identify factors associated with surgical success among patients at Kilimanjaro Christian Medical Centre (KCMC) and Comprehensive Community-Based Rehabilitation Hospital (CCBRT), Tanzania. Methods: We conducted a retrospective cohort study between August and December 2023. Data on demographics, pre- and postoperative clinical characteristics, surgical details, and outcomes were extracted from medical records using a structured data collection tool. Analyses were performed using SPSS version 27. The Friedman test was used to compare median pre- and postoperative visual acuity (VA). Generalized estimating equations with logistic regression assessed factors associated with macular hole closure, while gamma regression modelled postoperative logMAR VA, accounting for repeated measures. Statistical significance was set at p < 0.05. Ethical approval was obtained from the Institutional Review Board, and patient data were handled confidentially. Results: A total of 101 eyes were analysed, of which all had idiopathic macular holes. Preoperatively, the median logMAR VA was 1.2(Snellen 6/96). At three months, median VA improved to 1.00(Snellen 6/60), representing a gain of 0.20 logMAR (approximately two ETDRS lines; p < 0.001). Anatomical closure was achieved in 70% of eyes. Multivariable analysis showed that good preoperative VA increased the odds of macula hole closure (aOR 19.77; 95% CI 1.20–25.3; p = 0.037). The use of the conventional ILM flap technique was associated with an increase in logMAR VA (aβ = 0.05, 95% CI 0.01–0.08, p = 0.012). Anatomical closure correlated with significant visual improvement (p < 0.001). Effect sizes for VA changes were modest, reflecting limited but meaningful functional gain. Conclusion: Over two-thirds of eyes achieved anatomical closure with modest visual improvement. These findings confirm the effectiveness of macular hole surgery in resource-limited settings. Expanding surgical capacity and applying evidence-based techniques could further improve outcomes. Longer-term follow-up with optical coherence tomography is recommended to optimize treatment strategies and patient counselling.

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Cite

BibTeXRIS
BibTeX
@article{masuki2026visual,
  title = {{Visual and anatomical outcomes of full-thickness macular hole surgery and associated factors in selected hospitals in Tanzania}},
  author = {Heavenlight Estomihi Masuki and Jovin S. Sagale and Celina F. Mhina and Mustafa Yusufali and William Makupa and Milka Mafwiri},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0357451},
  url = {https://doi.org/10.1371/journal.pone.0357451},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Visual and anatomical outcomes of full-thickness macular hole surgery and associated factors in selected hospitals in Tanzania
AU  - Heavenlight Estomihi Masuki
AU  - Jovin S. Sagale
AU  - Celina F. Mhina
AU  - Mustafa Yusufali
AU  - William Makupa
AU  - Milka Mafwiri
PY  - 2026
DA  - 2026/09/08
JO  - PLOS One
DO  - 10.1371/journal.pone.0357451
UR  - https://doi.org/10.1371/journal.pone.0357451
AB  - Purpose: To determine the anatomical and visual outcomes of macular hole surgery and identify factors associated with surgical success among patients at Kilimanjaro Christian Medical Centre (KCMC) and Comprehensive Community-Based Rehabilitation Hospital (CCBRT), Tanzania. Methods: We conducted a retrospective cohort study between August and December 2023. Data on demographics, pre- and postoperative clinical characteristics, surgical details, and outcomes were extracted from medical records using a structured data collection tool. Analyses were performed using SPSS version 27. The Friedman test was used to compare median pre- and postoperative visual acuity (VA). Generalized estimating equations with logistic regression assessed factors associated with macular hole closure, while gamma regression modelled postoperative logMAR VA, accounting for repeated measures. Statistical significance was set at p < 0.05. Ethical approval was obtained from the Institutional Review Board, and patient data were handled confidentially. Results: A total of 101 eyes were analysed, of which all had idiopathic macular holes. Preoperatively, the median logMAR VA was 1.2(Snellen 6/96). At three months, median VA improved to 1.00(Snellen 6/60), representing a gain of 0.20 logMAR (approximately two ETDRS lines; p < 0.001). Anatomical closure was achieved in 70% of eyes. Multivariable analysis showed that good preoperative VA increased the odds of macula hole closure (aOR 19.77; 95% CI 1.20–25.3; p = 0.037). The use of the conventional ILM flap technique was associated with an increase in logMAR VA (aβ = 0.05, 95% CI 0.01–0.08, p = 0.012). Anatomical closure correlated with significant visual improvement (p < 0.001). Effect sizes for VA changes were modest, reflecting limited but meaningful functional gain. Conclusion: Over two-thirds of eyes achieved anatomical closure with modest visual improvement. These findings confirm the effectiveness of macular hole surgery in resource-limited settings. Expanding surgical capacity and applying evidence-based techniques could further improve outcomes. Longer-term follow-up with optical coherence tomography is recommended to optimize treatment strategies and patient counselling.
SN  - 1932-6203
ER  -