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Ignacio Olmedo, Matias Iglicki, Marcelo Zas; Internal Limiting Membrane peeling success for idiopathic macular hole closure. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1059. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the success of internal limiting membrane (ILM) peeling in the closure of idiopathic macular holes (IMH). Although the precise physiopathology of idiopathic macular holes remains unclear, the most accepted theory suggests that it is a consequence of anteroposterior dynamic vitreomacular traction and tangential traction caused by the ILM.
We performed Pars Plana Vitrectomy (PPV) combined with ILM peeling (using Brilliant Blue as stain), in 25 eyes of 21 patients. The diagnoses of idiopathic macular hole were made with indirect ophthalmoscopy and Macular Spectral Domain – Optical Coherence Tomography (SD-OCT). The principal signs and symptoms described were metamorphopsias and decreased visual acuity.
The average success of IMH closure using the described procedure was 88%. This means that IMH closed up in twenty-two out of the twenty-five eyes that underwent PPV with ILM peeling. Mean age was 66 years, and 65% of the patients were women. All of the patients with successful result report an improvement in their visual acuity quality and most of them improved at least in 1 or 2 lines in their visual acuity. No holes reopened until the date during the one year follow-up.
Considering the advances in vitrectomy techniques making it safer and the advances in the ILM peeling instruments, the indications for this type of surgery continue to expand. Several papers shown the success of PPV combined with ILM peeling for the closure of IMH. Alongside those papers, our study suggests that a complete vitrectomy combined with a correct ILM peeling will result in the closure of the macular hole in most of the cases.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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