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J. Reichelt, U. Butt, A. Lux, A. Joussen; Outcome of Pars Plana Vitrectomy in Macular Pucker and Macular Hole: Comparison of Cases With and Without Peeling of Internal Limiting Membrane. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4112.
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© ARVO (1962-2015); The Authors (2016-present)
Pars plana vitrectomy (Vy) is a successful method in treatment of macular pucker (MP) and macular hole (MH). Internal limiting membrane (ILM) peeling is performed to prevent recurrence of MP and release tangential traction in patients with MH. It remains unknown, whether ILM peeling results in a higher anatomical success rate.
Between 1999-2003 307 patients with MP and 407 with MH underwent Vy at the Univeristy of Cologne. ILM-peeling was performed in 105 of cases with MP and in 199 of cases with MH. Indocyanine Green was used peeling the ILM.
In Vy of MP with ILM peeling (group A) anatomical success could be obtained in 104 of 105 cases, without ILM peeling (group B) in 196 of 202. In Vy of MH with ILM peeling (group C) macular hole closure was achieved in 184 of 199 cases, without ILM-peeling (group D) in 193 of 208. Differences were statistically not significant. Complications were retinal detachments (5 in group A, 3 in group B, 4 in group C and 4 in group D; differences were not significant). Relapse of MP occurred in 1 (A) and 6 (B) cases; persisting MH was noticed in 15 (C) and 15 (D) cases.
According to our retrospective data, ILM peeling does not seem to have any explicit impact on the anatomical outcome of Vy of macular pucker and macular hole. Differences in recurrence in cases with MP were not significant. It will be elucidating to obtain further data of long-term follow-up.
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