[Macular hole surgery with and without internal limiting membrane peeling]

Abstract

Purpose: To determine if internal limiting membrane (ILM) peeling in idiopathic macular hole surgery improves anatomic and functional results.

Methods: Comparative retrospective, nonrandomized study, of 50 eyes from 48 patients with macular hole, Stage III an IV of the Gass Classification. All of them were operated with the same technique. In 25 eyes the ILM was peeled (group 1). In the other 25 eyes the ILM was not peeled (group 2). We compare the anatomic and functional outcome as well as the complications in both groups.

Results: The overall anatomic success rate in the 50 eyes was 92% (46 eyes). In group 1 the anatomic success rate was 100% and 84% in group 2 (p=0.018). The visual acuity improved, one or more Snellen lines, in 34 of the 50 operated eyes (68%). In group 1 the visual acuity improved in 20 of the 25 eyes (80%) and in group 2 in 14 of the 25 eyes (56%) (p=0.034). The most relevant complications included retinal detachment, two cases in group 1 and one case in group 2, cataract and retinal pigment epithelium changes.

Conclusions: In our experience, internal limiting membrane peeling in macular hole surgery improves the anatomic and functional success, but not the final visual acuity.