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J.R. Chao, T.S. Chang, J.I. Lim; A Comparison of Internal Limiting Membrane Peeling to No Internal Limiting Membrane Peeling in Macular Hole Repair: A Retrospective Review . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5425.
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Purpose: To compare visual acuity (VA) outcomes after pars plana vitrectomy (PPVx) with (+ILM) and without (–ILM) internal limiting membrane peeling in macular hole surgery in a series of consecutive patients over a four year period. Methods: Twenty four eyes underwent PPVx +ILM (13 eyes) or –ILM (11 eyes) followed by gas (16–18% C3F8) or silicone oil (two eyes per group). Follow–up was at least 12 months postoperatively. VA was compared in eyes +ILM and –ILM at 3, 6, and 12 months after surgery. Results: Mean ages were 67 years in +ILM and 65 years in –ILM groups respectively. Preoperative VA was similar for each group (VA ≤ 20/200: 69% +ILM and 63% –ILM; 20/80–20/100: 15% +ILM and 18% –ILM; 20/60–20/70: 15% +ILM and 18% –ILM). At three months postoperatively, 54% of +ILM eyes and 64% of –ILM eyes had VA within two lines of preoperative VA. Twenty three percent of +ILM eyes and 18% of –ILM eyes improved three or more VA lines; 23% of +ILM eyes and 18% of –ILM eyes lost three or more VA lines. At six months postoperatively, 46% of +ILM eyes and 45% of –ILM eyes had VA within two lines of preoperative VA. Fifteen percent of +ILM eyes and 18% of –ILM eyes improved three or more lines, while 38% of +ILM eyes and 36% of –ILM eyes lost 3 or more lines. At 12 months postoperatively, 54% of +ILM eyes and 36% of –ILM eyes remained within two lines of preoperative VA. Twenty three percent of +ILM and 45% of –ILM eyes improved 3 or more lines, while 23% of +ILM and 18% of –ILM eyes lost 3 or more lines. Conclusions: VA outcomes were similar for eyes undergoing pars plana vitrectomy with and without ILM peeling at 3 and 6 months postoperatively. At 12 months post–operatively, a moderately higher percentage of eyes improved 3 or more lines of VA in eyes without ILM peeling compared to eyes with ILM peeling. Prospective studies are needed to confirm the effect of ILM peeling on VA outcome.
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