COMPARISON OF VITRECTOMY WITH AND WITHOUT INTERNAL LIMITING MEMBRANE (ILM) PEELING FOR FULL THICKNESS MACULAR HOLE

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TABATABAEI S.A.; RIAZI ESFAHANI M.; MANSOURI M.R.; KHODAMI N.; JAVADIAN A.; SHAMS HORMOZ; KARKHANEH R.; FAGHIHI H.; MIRSHAHI A.; NILI AHMADABADI M.; FARAHVASH M.S.; LASHEYEI A.R.; ALAMI HARANDI Z.; MOVASAT M.

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Journal: JOURNAL OF CURRENT OPHTHALMOLOGY Year:2005 | Volume:18 | Issue:4 Page(s): 68-75

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Title

COMPARISON OF VITRECTOMY WITH AND WITHOUT INTERNAL LIMITING MEMBRANE (ILM) PEELING FOR FULL THICKNESS MACULAR HOLE

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Keywords

FULL THICKNESS MACULAR HOLEQ4

INTERNAL LIMITING MEMBRANE PEELINGQ4

DEEP VITRECTOMYQ3

OCTQ3

Abstract

Purpose: To compare the anatomical and functional results of DEEP VITRECTOMY with and without ILM peeling for FULL THICKNESS MACULAR HOLE.Materials & Methods: 37 eyes of 37 patients with FULL THICKNESS MACULAR HOLE (FTMH), confirmed by clinical examination and optical coherence tomography (OCT), enrolled in this clinical trial. Based on the stage of FTMH (stage 2, 3, 4) as described by Gass and the techniques of surgery (with or without ILM peeling) the patients were randomized into two different groups. All patients underwent preoperative Act and at least one OCT image was obtained during the postoperative follow up.After obtaining informed consent, DEEP VITRECTOMY and 20% SF6 injection was performed. The patients were unaware of their allocation status. Patients data & surgical outcome were collected and statistically analyzed. Anatomical success was defined as hole closure at postoperative OCT and functional success was referred to any improvement in visual acuity. Macular hole index (MHI) was defined as a ratio of the greatest height to the base diameter of the hole on cross-sectional OCT images.Results: 37 eyes of 37 patients (15 men & 22 women) were enrolled. The mean age of the patients was 56.4±21.94 years and FTMH were traumatic in 13 cases (35%) and Idiopathic in 24 (65%) cases. Twenty cases underwent DEEP VITRECTOMY with ILM peeling (ILM group) and the remaining cases underwent vitrectomy without ILM peeling (no ILM group).The mean preoperative 10gMAR visual acuity was 1.38±1 in the ILM group and 1.22±0.13 in the no ILM group, these improved to 0.95±1 and 0.77±0.31 postoperatively in the ILM and no ILM group, respectively (P=0.871). The overall anatomical success rate was 64%. The hole was closed in 70% of ILM peeling and 47% in the no ILM group (Chi-square test, P=0.15). In anatomically successful cases the mean of postoperative VA was significantly improved (P=0.001).In traumatic subgroup, ILM peeling seems did not affect the anatomical (P=0.2) and visual Success rates (P=0.5). There was no significant differences in hole closure rates between the traumatic and idiopathic FTMH (P=0.968). Visual acuity significantly improved after operation In MHI ³ 0.5 group compared with the MHk 0.5 group. The stage of the hole did not affect the anatomical success rate (P=0.52) or visual acuity improvement (P=0.741). Macular hole index ³ 0.5 had a prognostic value for postoperative visual acuity improvement. The hole duration was not related to anatomical success rate but there is an inverse relation between duration of the symptoms and improvement in VA.Conclusion: DEEP VITRECTOMY and SF6 injection was a safe & effective surgical technique for FULL THICKNESS MACULAR HOLE and peeling of the ILM seems did not affect the anatomical or functional success rates. The hole duration, stage and origin of the hole (traumatic or idiopathic) does not related to the anatomical success or visual acuity improvement. MHI ³ 0.5 seems to be a prognostic factor for postoperative visual improvement but not for closure rate.

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APA: Copy

TABATABAEI, S.A., RIAZI ESFAHANI, M., MANSOURI, M.R., KHODAMI, N., JAVADIAN, A., SHAMS, HORMOZ, KARKHANEH, R., FAGHIHI, H., MIRSHAHI, A., NILI AHMADABADI, M., FARAHVASH, M.S., LASHEYEI, A.R., ALAMI HARANDI, Z., & MOVASAT, M.. (2005). COMPARISON OF VITRECTOMY WITH AND WITHOUT INTERNAL LIMITING MEMBRANE (ILM) PEELING FOR FULL THICKNESS MACULAR HOLE. JOURNAL OF CURRENT OPHTHALMOLOGY, 18(4), 68-75. SID. https://sid.ir/paper/53071/en

Vancouver: Copy

TABATABAEI S.A., RIAZI ESFAHANI M., MANSOURI M.R., KHODAMI N., JAVADIAN A., SHAMS HORMOZ, KARKHANEH R., FAGHIHI H., MIRSHAHI A., NILI AHMADABADI M., FARAHVASH M.S., LASHEYEI A.R., ALAMI HARANDI Z., MOVASAT M.. COMPARISON OF VITRECTOMY WITH AND WITHOUT INTERNAL LIMITING MEMBRANE (ILM) PEELING FOR FULL THICKNESS MACULAR HOLE. JOURNAL OF CURRENT OPHTHALMOLOGY[Internet]. 2005;18(4):68-75. Available from: https://sid.ir/paper/53071/en

IEEE: Copy

S.A. TABATABAEI, M. RIAZI ESFAHANI, M.R. MANSOURI, N. KHODAMI, A. JAVADIAN, HORMOZ SHAMS, R. KARKHANEH, H. FAGHIHI, A. MIRSHAHI, M. NILI AHMADABADI, M.S. FARAHVASH, A.R. LASHEYEI, Z. ALAMI HARANDI, and M. MOVASAT, “COMPARISON OF VITRECTOMY WITH AND WITHOUT INTERNAL LIMITING MEMBRANE (ILM) PEELING FOR FULL THICKNESS MACULAR HOLE,” JOURNAL OF CURRENT OPHTHALMOLOGY, vol. 18, no. 4, pp. 68–75, 2005, [Online]. Available: https://sid.ir/paper/53071/en

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