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Nicolò Scaroni, Francesco Morescalchi, Andrea Russo, Elena Gambicorti, Ciro Costagliola, Francesco Semeraro; Foveal sparing internal limiting membrane peeling for Lamellar Macular Hole.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5007.
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© ARVO (1962-2015); The Authors (2016-present)
To study the effects of vitrectomy with foveal sparing of the Internal limiting membrane (ILM) peeling as an alternative method of lamellar macular hole (LMH) treatment.
A Prospective study was performed including 13 patients affected by tractional and degenerative LMH. They underwent pars plana vitrectomy using transconjuntival 25-gauge system. After the removal of the posteriore hyaloid and epiretinal membrane, the ILM was peeled in a curvilinear manner centered around the fovea. Air tamponade was performed. All the cases underwent microperimetry analysis at baseline and at 1, 3, and 6-month after the surgery.
It was found a significant improvement in mean BCVA (preoperative VA was logMar+0.52 20/63 ±0.27, post operative VA at 6 months was logMar0.13 ±0.09) , and in mean central 5 degrees retinal sensitivity (preoperative 9,2 ± 2,4dB, postoperative at 6month 11,7 ± 2,3 dB). No patient developed a full thickness macular hole or secondary epiretinal membrane formation.
In LMH the foveal sparing ILM peeling technique shows high rates of success. Furthermore this approach could be a less traumatic procedure that allows to better preserve the anatomical integrity of the thinned fovea, reducing the risk of post operative macular hole.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
It illustrates the sequences of foveal sparing internal limiting membrane (ILM) peeling. The ILM is grasped several times near the arcades apulled in a centripetal fashion. The remaining floating flap is finally trimmed by the vitrectome.
Above- tractional lamellar macular hole before surgery Under- the same case at 3 month after surgery. it may notice the restoration of normal foveal depression and residues of ILM coated on the foveola
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