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S. W. Lee, S. Kang, M. Kim; Vitrectomy for Symptomatic Impending Macular Holes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1320.
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Although the Vitrectomy for Prevention of Macular Hole Study Group did not show a benefit and advantage of vitrectomy for impending macular holes about 10 years ago, there have been notable improvements in the diagnosis and efficacy of treatment in the ensuing years. This study aimed to identify the effect of current vitreous surgery for symptomatic impending macular holes.
We reviewed 19 eyes in 17 consecutive patients who had undergone vitrectomy with internal limiting membrane peeling and intraocular air or short-acting gas tamponade for symptomatic impending macular holes. Pre-operatively, all of the patients had outer foveal defects on optical coherence tomography (OCT). We analyzed the visual outcome and the change in foveal appearance on OCT.
The follow-up period ranged from 3-41 months, with a mean of 13.5 months. The mean logMAR best-corrected visual acuity (BCVA) improved from 0.42 to 0.11 post-operatively (P=0.00, paired t-test). The post-operative OCT examination revealed anatomic closure with complete disappearance of the outer foveal defect in all of the cases.
In symptomatic patients with impending macular holes, current vitreous surgery may prevent progression to full-thickness macular holes and improve the visual outcome. A randomized controlled trial is warranted.
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