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R Uemoto, S Yamamoto, T Aoki, I Tsukahara, T Yamamoto, S Takeuchi; Macular Configuration Determined By Optical Coherence Tomography After Idiopathic Macular Hole Surgery With Or Without Internal Limiting Membrane Peeling . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2475.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To evaluate the effect of internal limiting membrane (ILM) peeling combined with pars plana vitrectomy on the closure and configuration of idiopathic macular holes (IMH). Methods:Pars plana vitrectomy for IMH combined with ILM peeling (ILM peeled group) was performed on 44 eyes, and without ILM removal (ILM preserved group) on 42 eyes. Optical coherence tomography (OCT) was performed on 34 ILM peeled eyes and 14 ILM preserved eyes after successful surgery. The repaired macular holes were classified by the OCT images as being in "fair-shape" (nearly normal foveal contour) or "poor-shape" (abnormal foveal contour with flat fovea and steep edge, or with thick undepressed fovea). Results:The anatomic success rate was significantly higher in the ILM peeled group (93.2%) than in the ILM preserved group (76.2%) (P=0.028). In the ILM peeled group, 31 eyes showed a fair-shape and 3 eyes showed poor-shape, while in the ILM preserved group, 6 eyes showed fair-shape and 8 eyes showed poor-shape. The macular configuration was significantly improved in the ILM peeled group (P=0.0003). No significant difference was found in the postoperative visual acuity and the increase of visual acuity postoperatively between the two groups (P=0.26, and P=0.91 respectively). There was also no significant difference between eyes with a fair-shape and those with the poor-shape fovea in the postoperative visual acuity and improvement of the visual acuity (P=0.99, and P=0.66 respectively). Conclusion:ILM peeling may provide better anatomic success and recovery of the macular shape, however, the postoperative visual acuity and improvement of visual acuity was not related to the morphological results.
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