Vitreous Surgery With and Without Internal Limiting Membrane Peeling for Macular Hole Repair

Kumagai, Kazuyuki; Furukawa, Masao; Ogino, Nobuchika; Uemura, Akinori; Demizu, Seiji; Larson, Eric

doi:10.1097/00006982-200410000-00006

Cited by 109 publications

(72 citation statements)

References 27 publications

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“…These include stage of the hole, hole duration, hole size, preoperative visual acuity, and whether or not peeling of the ILM is performed. [7][8][9][10] Various studies have confirmed that shorter hole duration and lower stage of macular hole, together with ILM peeling at the time of surgery are associated with a higher anatomical closure rate. 8,9 However, the role of posturing in macular hole surgery remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Various studies have confirmed that shorter hole duration and lower stage of macular hole, together with ILM peeling at the time of surgery are associated with a higher anatomical closure rate. 8,9 However, the role of posturing in macular hole surgery remains controversial. A study designed to objectively evaluate the time of post-operative posturing by patients undergoing macular hole surgery questioned the importance of posturing in determining the success of macular hole surgery.…”

Section: Discussionmentioning

confidence: 99%

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Functional outcome and patient preferences following combined phaco-vitrectomy for macular hole without prone posturing

Madgula

Costen

2007

Eye

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Background Macular hole surgery varies widely regarding the duration of gas tamponade, the use of patient posturing post-operatively, and whether or not cataract extraction is undertaken at the same time. Aim To analyse anatomical and functional success rate following macular hole surgery and to examine patient preferences regarding posturing and length of gas tamponade. Materials and methods Study design.Prospective, interventional and noncomparative case series. Participants. Thirty patients with stage III and IV full-thickness macular hole who underwent macular hole repair during the period April 2005-January 2006. Intervention. All eyes underwent a standard three-port pars plana vitrectomy, removal of posterior vitreous, internal limiting membrane (ILM) peel, C3F8 gas tamponade, and cataract extraction with IOL implantation. Patients did not posture post-operatively. Outcome measures. Post-operative anatomic results, visual acuity, complications, patient preferences regarding surgical protocol, and subjective improvement in visual function. Results Patients were followed up postoperatively for 6 months. Primary anatomical hole closure was achieved in 96.7% eyes. Visual acuity improved in 83.8% patients. Two patients had raised intraocular pressure following surgery. A total of 96.9% of patients were happy with no posturing and a 2-month gas bubble.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional outcome and patient preferences following combined phaco-vitrectomy for macular hole without prone posturing

Madgula

Costen

2007

Eye

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“…24 Notwithstanding, the exact mechanism underlying the success remains equivocal. Some investigators argue that it is because of a reduction in vitreoretinal tangential traction; 23 others support the notion that glial proliferation is stimulated, resulting in an increased macular hole closure rate.…”

Section: Discussionmentioning

confidence: 99%

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

Heath

Rahman

2010

Eye

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“…Several reports also indicated that experienced surgeons could achieve an anatomical closure rate of more than 90% after ILM peeling for macular holes. [2][3][4][5] Although there are other dyes with greater safety, including trypan blue and brilliant blue G, ICG still remains the standard for staining transparent ILM by some surgeons in some countries due to its greater availability and its optimal, selective staining of ILM. However, the potential adverse effects of ICG on retinal tissues remain a concern.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Internal limiting membrane (ILM) removal can further relieve foveal traction from within the retinal surface and provide good anatomical and functional results with high closure and low reopening rates. 4,5 Staining ILM with a dye can facilitate visualization of the ILM during surgery and help complete removal. Among different dyes, indocyanine green (ICG) was first used for ILM staining and remained the standard in some countries because the staining of ILM and the ease of ILM removal were optimum with ICG.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Autologous Serum on Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Hole

Kung

2013

Journal of Ocular Pharmacology and Therapeutics

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Purpose: We sought to evaluate the effects of intraoperative adjunctive autologous serum in idiopathic fullthickness macular hole surgeries, and to compare the surgical outcomes with a no-serum control group. Methods: In this retrospective, case-control study, 38 consecutive eyes received vitrectomy with internal limiting membrane removal for idiopathic full-thickness macular holes. Two groups were created according to the use of autologous serum. Outcome measures were visual acuity (VA), closure of the macular hole confirmed by optical coherence tomography, and surgical complications. Results: Anatomical closure of the macular hole was achieved in 18 of 19 eyes (94.7%) in the vitrectomy with the autologous serum group, and in 18 of 19 eyes (94.7%) in the control group. The closure rates did not differ significantly between 2 groups (P = 1.000; the Fisher's exact test). At the final follow-up, the mean logMAR VA improved significantly in both groups (SD, standard deviation) [from 1.08 (0.21) to 0.47 (0.21) in vitrectomy with the serum group and from 1.01 (0.32) to 0.44 (0.30) in the control group (both P < 0.001; 2 tailed, paired t test)]. There was no significant difference between these 2 groups in terms of visual outcomes (P = 0.738; 2-tailed t test). There were no surgical complications, such as retinal detachment and endophthalmitis. Conclusions: The outcome of macular hole surgery did not differ both anatomically and functionally regardless of the use of adjuvant autologous serum. There seemed to be no additive effect with autologous serum.

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Vitreous Surgery With and Without Internal Limiting Membrane Peeling for Macular Hole Repair

Abstract: Internal limiting membrane peeling shows high closure and low reopening rates in macular hole surgery. ILM peeling is beneficial in older holes but is limited in larger holes. ILM peeling does not significantly improve visual acuity.

Cited by 109 publications

References 27 publications

Functional outcome and patient preferences following combined phaco-vitrectomy for macular hole without prone posturing

Functional outcome and patient preferences following combined phaco-vitrectomy for macular hole without prone posturing

Combined 23-gauge, sutureless transconjunctival vitrectomy with phacoemulsification without face down posturing for the repair of idiopathic macular holes

The Effect of Autologous Serum on Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Hole

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