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. 1999 Jul;106(7):1392-7; discussion 1397-8.
doi: 10.1016/S0161-6420(99)00730-7.

Macular hole surgery with internal-limiting membrane peeling and intravitreous air

D W Park  1 , J O Sipperley, S R Sneed, P U Dugel, J Jacobsen
Affiliations

Macular hole surgery with internal-limiting membrane peeling and intravitreous air

D W Park et al. Ophthalmology. 1999 Jul.

Abstract

Objective: To examine the results of macular hole surgery using pars plana vitrectomy, internal-limiting membrane peeling, and intravitreous air in a series of consecutive patients.

Design: A retrospective, interventional, noncomparative case series.

Patients: Fifty consecutive patients (58 eyes) with full-thickness macular holes.

Intervention: All eyes underwent a pars plana vitrectomy with internal-limiting membrane peeling and intravitreous air, and patients were asked to position face-down for only 4 days.

Main outcome measures: Status of macular holes, visual acuity, and associated findings and complications.

Results: All patients had postsurgical follow-up of 6 months or greater. Eight eyes (14%) presented with stage-2 macular holes, 48 eyes (83%) with stage-3 macular holes, and 2 eyes (3%) with stage-4 macular holes. Only 26 eyes (45%) had a macular epiretinal membrane seen before surgery. Fifty-three (91 %) of the 58 macular holes were closed with 1 operation, and 55 (95%) had closure of the macular holes with subsequent operations. Five (9%) of 58 eyes had an initial visual acuity of 20/50 or better, and 31 eyes (53%) had a final visual acuity of 20/50 or better. Of the 45 eyes with symptoms of less than 6 months' duration, 44 (98%) had macular holes that were closed with 1 operation and 27 (60%) had a final visual acuity of 20/50 or better. Of the 13 eyes with symptoms of 6 months' duration or longer, 9 (69%) had macular holes that were closed with 1 operation and 4 (31 %) had a final visual acuity of 20/50 or better. Complications attributed to the operation included retinal tears, retinal detachments, postoperative macular puckers, and macular light toxicity.

Conclusions: The anatomic and visual results in this series are good. The current technique is similar to that of conventional macular hole surgery except for the use of intravitreous air, internal-limiting membrane peeling in all eyes, and only 4 days of postoperative positioning. This study would suggest that peeling of the internal-limiting membrane is an important adjuvant for successful closure of macular holes.

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Comment in

  • Macular hole surgery in high myopia.
    Yuen CY, Cheung BT, Lam DS. Yuen CY, et al. Ophthalmology. 2002 Feb;109(2):219. doi: 10.1016/s0161-6420(01)00965-4. Ophthalmology. 2002. PMID: 11825792 No abstract available.

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