Purchase this article with an account.
L. Akduman, O. Oz, S.J. Fudemberg, M.P. Jones; Predictors of Success in Macular Hole Surgery with Emphasis on Internal Limiting Membrane (ILM) and ILM Peeling . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4038.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: We studied the predictors of success in macular hole surgery with particular emphasis on the internal limiting membrane (ILM) and ILM peeling. Methods: Twenty-three eyes of 22 consecutive patients with stage 2, 3, or recurrent macular hole underwent pars plana vitrectomy, and intraocular tamponade with C3F8 or silicone oil. Duration of macular hole varied between 1 to 84 months (median=3 months). The association of clinically prominent ILM with the stage and the duration of the macular hole was determined. The ILM was peeled only when it was clinically prominent. Macular hole closure rate and the visual improvement were studied based on the preoperative visual acuity, stage and duration of the macular hole, the type of the intravitreal tamponade used and ILM peeling. Results: Macular hole was anatomically closed in 19 of the 23 eyes and visual improvement of 2 lines or more was achieved in 18 of the 23 eyes. The ILM was clinically prominent in 15 eyes; the ILM was peeled totally in 10 of these 15 eyes, and partially in the 5 others. None of the variables (preoperative visual acuity, stage or duration of the macular hole, type of the intraocular tamponade used, and ILM peeling) affected the anatomical or visual outcome. Macular hole was closed in 8 of the 10 eyes which underwent total ILM removal; 4 of the 5 eyes which underwent partial ILM removal; 7 of the 8 eyes in which no ILM peeling was attempted. Visual improvement was obtained in 8 of the 10 eyes which underwent total ILM removal; 4 of the 5 eyes which underwent partial ILM removal; 6 of the 8 eyes in which no ILM peeling was attempted. Conclusions: Stage or duration of the macular hole, type of the intraocular tamponade used, and ILM peeling do not seem to affect the closure rate and visual outcome in patients undergoing macular hole surgery. The visual outcome in cases where clinically prominent ILM was peeled seems to be the same good as in cases where the ILM was not prominent and no peeling was attempted. We recommend consideration of ILM peeling only if the ILM is clinically prominent.
This PDF is available to Subscribers Only