Fovea-Sparing Versus Complete Internal Limiting Membrane Peeling in Vitrectomy for Vitreomacular Interface Diseases

Abstract

Supplemental Digital Content is Available in the Text. A meta-analysis was conducted and found that vitrectomy with fovea-sparing internal limiting membrane peeling resulted in better visual outcomes when treating vitreomacular interface diseases and reduced the incidence of full-thickness macular hole in nonmacular hole cases.

Prevalence and Associations of Vitreomacular Traction: The Beijing Eye Study

“…The findings in our study may have clinical importance, since VMT may associate with several pathological processes of posterior poles, such as MH, CME, ERM, [2][3][4][5] and even agerelated macular degeneration. 5,10,11 Further studies may assess whether the results of our study help in understanding the pathogenesis of these disorders by showing the correlations of VMT and other ocular and general parameters.…”

“…The findings in our study may have clinical importance, since VMT may associate with several pathological processes of posterior poles, such as MH, CME, ERM, 2–5 and even age-related macular degeneration. 5 , 10 , 11 Further studies may assess whether the results of our study help in understanding the pathogenesis of these disorders by showing the correlations of VMT and other ocular and general parameters. If that is the case, one may hypothetically consider that releasing the vitreomacular traction artificially either by operation or drugs, 23 , 24 such as ocriplasmin, may control or cure the associated diseases.…”

“…1 VMT is considered to be associated with a broad spectrum of macular diseases, including cystoid macular edema (CME), epiretinal membrane (ERM) and macular hole (MH), all of which are attributed to common etiology. [2][3][4][5] The hallmark of VMT is a persistent attachment of the vitreous to the macula in eyes with an incomplete posterior vitreous detachment. In the most common form of VMT syndrome, as initially described, 6 the vitreous is separated from the retina throughout the peripheral fundus but remains adherent posteriorly, producing anteroposterior traction on a narrow region of several optic disc areas, usually dumbbell-shaped areas, encompassing macular areas and optic nerves.…”

“…2,7,8 Traction on the retina at the macula causes decreased vision, metamorphopsia, photopsia, and micropsia. [2][3][4][5][7][8][9][10] Among vitreoretinal interface abnormalities, VMT syndrome is probably one of the conditions which has been significantly improved in terms of pathophysiologic concepts.…”

Vitrectomy for macular retinoschisis associated with peripapillary intrachoroidal cavitations in a moderately myopic eye

“…Macular holes are one of the most serious postoperative complications of vitrectomy with ILM peeling for myopic traction maculopathy [ 20 , 21 ]. FSIP reduce the risk of postoperative full-thickness macular hole in vitreous surgery for vitreomacular traction syndrome and macular retinoschisis in highly myopic eyes [ 22 – 24 ]. In the present case, an outer lamellar macular hole was observed preoperatively, and the ILM was the only intact foveal tissue.…”