Timing of macular hole surgery among vitreoretinal surgeons in the UK: A national survey, review of literature and future direction.

To survey current practice and opinion regarding the timing of idiopathic full thickness macular hole (iFTMH) surgery among consultant vitreoretinal surgeons in the United Kingdom (UK), and to provide an overview of the current literature and future direction. An online survey was sent to all members of the British and Eire Association of Vitreoretinal Surgeons (BEAVRS). Literature search and analysis were conducted on studies that investigated the timing of vitrectomy surgery for iFTMH. A total of 33 responses was received from all regions of the UK except Northern Ireland. The timing from the onset of symptoms to the first vitreoretinal clinic appointment ranged from 1 to 60 months, with a mean of 6.66 ± 10.8 months (95% CI 2.75-10.6). In terms of surgical prioritisation on the listing form, 42.4% (n = 14) were listed as P2 (less than 1 month), 54.5% (n = 18) were listed as P3 (less than 3 months), and 3.03% (n = 1) were listed as P4 (more than 3 months). The average time from the onset of symptoms to operation date in this cohort was 9.87 months. When asked in an ideal world, would they have liked the surgery to be done sooner, the majority (72.7%, n = 24) said 'yes'. The survey found that there were regional variations in waiting times and surgical prioritisation. Expanding teleophthalmology and establishing elective vitreoretinal surgical hubs are crucial for ensuring timely access to care for all iFTMH patients in the UK.