The impact of extent of internal limiting membrane peeling on anatomical outcomes of macular hole surgery: results of a 54-week randomized clinical trial.
Aged
Basement Membrane
/ surgery
Female
Fluorescein Angiography
/ methods
Follow-Up Studies
Fundus Oculi
Humans
Macula Lutea
/ pathology
Male
Middle Aged
Prospective Studies
Retinal Perforations
/ diagnosis
Time Factors
Tomography, Optical Coherence
/ methods
Treatment Outcome
Visual Acuity
Vitrectomy
/ methods
anatomical outcomes
different diameter of internal limiting membrane peel
functional outcomes
internal limiting membrane peeling
macular hole
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
30
12
2017
accepted:
20
05
2018
pubmed:
7
9
2018
medline:
25
4
2019
entrez:
7
9
2018
Statut:
ppublish
Résumé
To compare the anatomical outcomes of different extents of internal limiting membrane (ILM) peeling in idiopathic macular hole surgery. Prospective, parallel-group, randomized clinical trial. A total of 121 eyes of 121 patients with idiopathic macular hole underwent pars plana vitrectomy, and peeling of the ILM with a diameter of two disk diameters (DD) or 4DD based on randomization. The main outcome was the proportion of eyes with complete hole closure at 12 months. The second outcome was the hole closure grading stratified by macular hole closure index (MHCI) at each visit. At 12 months, there was no significant difference in anatomical outcomes with complete closure achieved in 52 (82.5%) of 63 eyes in the 2DD group and 53 (91.4%) of 58 eyes in the 4DD group (p = 0.15). For subjects with MHCI ≤0.5 (n = 24), complete closure rate was significantly lower in the 2DD group compared to the 4DD group (p = 0.012; 18.2% versus 75.9%, respectively). Average BCVA was lower in 2DD group than 4DD group (p = 0.014). By contrast, when MHCI was >0.5, the complete closure rate between the two groups showed no significant difference: 96.2% (50 patients) versus 95.6% (43 patients), respectively (p = 0.185). In patients with idiopathic full-thickness macular hole and MHCI ≤0.5, a larger ILM peel of 4DD tends to achieve better anatomical outcomes than a more limited 2DD peel.
Identifiants
pubmed: 30187641
doi: 10.1111/aos.13853
pmc: PMC6585771
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-312Subventions
Organisme : Beijing Municipal Science and Technology Commission
ID : Z161100000516037
Organisme : National Natural Science Foundation of China
Informations de copyright
© 2018 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
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