Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Dec;260(12):3837-3845.
doi: 10.1007/s00417-022-05739-x. Epub 2022 Jul 6.

A retrospective, multicenter study on the management of macular holes without residual internal limiting membrane: the refractory macular hole (ReMaHo) study

Umberto Lorenzi  1   2 , Joel Mehech  1 , Tommaso Caporossi  3   4 , Mario R Romano  5 , Rocco De Fazio  6 , Eric Parrat  2   7 , Frédéric Matonti  2   8   9   10 , Paolo Mora  11 ; ReMaHo Study Group
Collaborators, Affiliations
Multicenter Study

A retrospective, multicenter study on the management of macular holes without residual internal limiting membrane: the refractory macular hole (ReMaHo) study

Umberto Lorenzi et al. Graefes Arch Clin Exp Ophthalmol. 2022 Dec.

Abstract

Purpose: To evaluate the surgical management, outcomes and prognostic factors of full thickness macular holes without residual internal limiting membrane (NO-ILM FTMHs).

Methods: We performed a multicenter, retrospective study of 116 NO-ILM FTMHs. Human amniotic membrane (hAM) plug, autologous ILM free flap transplantation (AILMT), and autologous retinal graft transplantation (ART) were performed in 58, 48, and 10 patients, respectively. Data were collected before and up to 12 months after surgery. The primary outcomes were hole closure and final best-corrected visual acuity (BCVA).

Results: The final BCVA (0.78 ± 0.51 logMAR) was significantly better than and correlated with the initial BCVA (p < 0.0001 and p = 0.004, respectively). Hole closure was achieved in 92% of eyes. The minimum FTMH diameter was wider and final BCVA was lower in the ART group than in the other groups (p < 0.003 and p < 0.001, respectively). FTMHs with diameter > 680 μm had a higher closure rate with hAM than with AILMT (p = 0.02).

Conclusions: AILMT and hAM were the most frequently performed surgeries with both high closure rate and significant functional improvement. Preoperative BCVA was correlated with final BCVA. The minimum FTMH diameter may guide the treatment choice.

Keywords: Full thickness macular hole; No internal limiting membrane; Prognostic variables; Reconstructive surgery.

PubMed Disclaimer

Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any or entity with any financial interest (such as honoraria; educational grants; participation in speaker’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest, and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Reference optical coherence tomography images to standardize measurements and surveys on the de-identified data records
Fig. 2
Fig. 2
Visual acuity variations in the whole cohort and in each surgical subgroup during the follow-up. BCVA: best-corrected visual acuity (in logMAR units); GEN: the whole cohort; AILMT: autologous internal limiting membrane free flap transplantation group: ART: autologous retinal graft transplantation group; hAM: human amniotic membrane group
See this image and copyright information in PMC

References

    1. Gu C, Qiu Q. Inverted internal limiting membrane flap technique for large macular holes: a systematic review and single-arm meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2018;256(6):1041–1049. doi: 10.1007/s00417-018-3956-2. - DOI - PubMed
    1. Frisina R, Gius I, Tozzi L, Midena E. Refractory full thickness macular hole: current surgical management. Eye (Lond) 2021 doi: 10.1038/s41433-020-01330-y. - DOI - PMC - PubMed
    1. Fekrat S, Wendel RT, de la Cruz Z, Green WR. Clinicopathologic correlation of an epiretinal membrane associated with a recurrent macular hole. Retina. 1995;15(1):53–57. doi: 10.1097/00006982-199515010-00010. - DOI - PubMed
    1. Thompson JT, Smiddy WE, Glaser BM, Sjaarda RN, Flynn HW., Jr Intraocular tamponade duration and success of macular hole surgery. Retina. 1996;16(5):373–382. doi: 10.1097/00006982-199616050-00002. - DOI - PubMed
    1. Ip MS, Baker BJ, Duker JS, et al. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography. Arch Ophthalmol. 2002;120(1):29–35. doi: 10.1001/archopht.120.1.29. - DOI - PubMed

Publication types

LinkOut - more resources