Abstract
Purpose::
Since there is no gold standard for lamellar macular hole treatment, evaluation of vitrectomy and peeling in patients with lamellar macular hole was performed regarding anatomical and functional outcome.
Methods::
10 patients with lamellar macular hole underwent vitrectomy, peeling (ERM/ILM) and gas- or silicone oil (n=1) endotamponade. Silicone oil had been removed by the time of follow-up examination. In most patients (n=9) cataract surgery was also performed. Pre- and postoperative OCT findings, visual acuity and Birkhaeuser near visual acuity were evaluated.
Results::
Follow-up was at least 6 months, mean follow-up 15±11 months after surgery. BCVA improved in all patients, the average gain of BCVA was 3 ± 2 lines. Preoperative mean BCVA was 0.35 (0.45logMAR±0.23) and postoperative BCVA 0.64 (0.19logMAR±0.21). 80% had a postoperative BCVA ≥ 20/40, 60% a postoperative BCVA ≥ 20/25. Mean near visual acuity was 0.5±0.26 (range: 0.2-0.9). Postoperative OCT revealed a closed lamellar macular hole in 6 patients, with restored foveal contour in 3 of them. The other four patients showed a persistent inner retinal defect of different size with intact photoreceptor layer.
Conclusions::
Surgical treatment including vitrectomy, peeling and endotamponade appears to be a beneficial treatment for patients with lamellar macular hole. All patients improved functionally, 60% had a postoperative BCVA ≥ 20/25. Surgical treatment can close the lamellar macular hole and restore the foveal architecture.
Keywords: macular holes • vitreoretinal surgery • visual acuity