Influence of Internal Limiting Membrane Peeling on the Macular Sensitivity in Viterctomy for Idiopathic Macular Holes

Abstract

Abstract: : Purpose: To elucidate the influence of internal limiting membrane (ILM) peeling during the viterctomy for idiopathic macular holes. Methods: Prospective uncontrolled study.Twenty eyes of 19 patients with idiopathic macular holes were enrolled in this study. All the patients received vitrectomy with ILM peeling using indocyanine green dye, combined with phaco–emulcification cataract extraction and intraocular lens implantation. The microperimetry by scanning laser ophthalmoscope (SLO) was performed in all the eyes prior to the surgery, and 2, 6 and 12 months postoperatively to evaluate scotomas around the macular holes, in the area of ILM peeling, and in the areas periphery to the ILM peeling. And the sensitivity in and around the macular holes was compared before and after the surgery. Results: The macular holes were confirmed to be closed by optical coherence tomography (OCT) in all the cases after the surgery. The scotomas were detected in and around the holes before the surgery in all the cases. These scotomas disappeared in 3 of 20 eyes (13%) at 2 months, in 12 eyes (60%) at 6 months and 13eyes (65%) at 12months. No scotomas were detected in the area of ILM peeling and in the area periphery to the ILM peeling either before or after the surgery. The visual acuity of the operated eyes improved in all the cases, and the quality of the visual acuity after the surgery was correlated to the acuity before the surgery and with the stage of the holes. Conclusions: The ILM peeling in the vitrectomy for idiopathic macular holes was considered not to influence the retinal sensitivity in and around the area of ILM peeling. The scotomas detected in and around the macular holes before the surgery gradually reduced or disappeared as the time advanced.

Keywords: macular holes • vitreoretinal surgery • visual fields