Long-term Outcome of Idiopathic Macular Hole Surgery

Passemard, M.; Yakoubi, Y.; Muselier, A.; Hubert, I.; Guillaubey, A.; Bron, Alain M.; Berrod, J.–P.; Creuzot‐Garcher, Catherine

doi:10.1016/j.ajo.2009.08.003

Cited by 53 publications

(28 citation statements)

References 37 publications

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“…After all inclusion criteria were applied, there were 50 articles that fulfilled the prerequisites: 7 studies had arms evaluating both ILM peeling and non-ILM peeling, 3,9,11,[15][16][17][18] 13 studies evaluated non-ILM peeling only, [19][20][21][22][23][24][25][26][27][28][29][30][31] and 30 studies evaluated ILM peeling only. [4][5][6][7][8]10, Figure 1 shows the flow chart of the selection process used to identify the studies concerned. The relevant information from these articles is summarized in Tables 1 and 2 (non-ILM peeling and ILM peeling, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…16,19 Notably, one study observed that 19.8% of cases (17 of 86 eyes) experienced recurrence of a previously closed hole after cataract extraction 16 ; however, numerous other reports in this meta-analysis have found no correlation between the two events. 5,6,10,20,26,27,29,44 The presence of cystoid macular edema, resulting in mechanical stress and disruption of the foveolar anatomy, has also been thought to play a role in the reopening of holes. 16,20 This has been called into question by a recent study describing five eyes with surgically repaired idiopathic macular holes that subsequently developed cystoid macular edema, yet maintained hole closure throughout the follow-up period.…”

Section: Meta-analysis Quality Discussionmentioning

confidence: 99%

“…During this time, there have been evolutionary changes in macular hole surgery, with success rates having improved significantly from the initially reported 58% 2 to .90% in most recent series. [3][4][5][6][7][8][9][10][11][12] In the mid to late 1990s, internal limiting membrane (ILM) peeling as part of the procedure emerged as a surgical step to help potentially improve closure rates and prevent postoperative reopening, one of the known long-term complications of successfully closed macular holes. 3,[12][13][14] Although initially met with a great deal of skepticism, removal of the ILM during macular hole repair has gradually gained widespread acceptance throughout the ophthalmologic community.…”

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confidence: 99%

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Impact of Internal Limiting Membrane Peeling on Macular Hole Reopening

Rahimy

McCannel

2016

Retina

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Section: Resultsmentioning

confidence: 99%

Section: Meta-analysis Quality Discussionmentioning

confidence: 99%

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confidence: 99%

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Impact of Internal Limiting Membrane Peeling on Macular Hole Reopening

Rahimy

McCannel

2016

Retina

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“…21 ILM peeling is currently thought to be an effective adjunct to achieve a higher macular hole closure rate and to prevent late reopening. 16,17 This involves inserting the relatively large membrane-peeling forceps through the sclerotomy and traversing the vitreous base. Insertion of the forceps can cause a localised retinal dialysis while withdrawal of the forceps can lead to a tractional retinal break at the entry site by pulling on the vitreous frill around the internal lip of the sclerotomy.…”

Section: Discussionmentioning

confidence: 99%

20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes

Krishnan

Tossounis

Yang

2012

Eye

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Purpose To assess and compare the complications and long-term visual and anatomical outcomes of 20-and 23-gauge phacovitrectomy (PVT) for idiopathic macular hole repair. Methods A retrospective, consecutive, interventional case series of 72 eyes with idiopathic macular holes were managed with 20-gauge PVT (n ¼ 36) or 23-gauge PVT (n ¼ 36). All patients underwent a posteriorchamber intra-ocular lens implantation and internal-limiting-membrane peel with the aid of either trypan blue or brilliant blue G 250 dyes. Results The macular hole closure rate was 97% with 20-gauge PVT and 100% with 23-gauge PVT. Mean follow-up was 24.06 ( ± 12.83) months with 20-gauge PVT and 17.47 ( ± 5.79) with 23-gauge PVT. Mean visual acuity improvement in LogMar was 0.41 ( ± 0.32) with 20-gauge PVT and 0.52 (±0.25) with 23-gauge PVT (P ¼ 0.135). The incidence of retinal breaks was higher with the 20-gauge PVT compared with the 23-gauge PVT, occurring in 13 (36.1%) and 4 (11.1%) cases, respectively (P ¼ 0.025). There were no cases of retinal detachment. Postoperative intraocular pressure (IOP), at day 1, was significantly higher with 20-gauge PVT at 24.77 (±12.68) mm Hg compared with 17.20 (±6.95) mm Hg in 23-gauge PVT (P ¼ 0.0028). Operating times were longer in 20-gauge PVT at 89.36 ( ± 15.26) min compared with the 23-gauge PVT at 79.33 ( ± 23.82) min (P ¼ 0.04). Conclusion The 20-gauge PVT compared with 23-gauge PVT for macular hole repair is a slightly longer procedure and was associated with an increased incidence of retinal breaks and short-term elevated IOP. Both techniques have comparable visual and anatomical outcomes, but the 23-gauge PVT has advantages with regard to safety profile and operating time.

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“…24 In the NOD study, 4.2% of eyes with MH underwent repeat PPV. 21 A recent study has reported a need for subsequent cataract surgery in approximately 50−65% of patients within 1 year of PPV for MH.…”

Section: Treatment Of Vmt With Mhmentioning

confidence: 99%

Redesigning services for the management of vitreomacular traction and macular hole

Amoaku

Cackett

Tyagi

et al. 2014

Eye

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Vitreomacular traction (VMT) and VMT with macular hole (MH) are serious conditions, being associated with visual disturbance, for example, metamorphopsia, and diminished visual acuity (VA). Pars plana vitrectomy is the routine treatment for symptomatic VMT and VMT+MH. However, ocriplasmin has demonstrated favourable efficacy and safety in specific patient groups with VMT/MH and is now recommended as a treatment option for certain patients by the National Institute of Health and Care Excellence. This means that services for managing patients with VMT/MH may need to be revised, as patients can now potentially receive treatment earlier in the course of the disease. VMT triage clinics could provide a more efficient way of managing VMT/MH patients. Patient assessment should always include high-definition optical coherence tomography, as this is the most accurate means of assessing abnormalities in the vitreoretinal (VR) interface, and an accurate measurement of best-corrected VA. It has been proposed that patients with VMT+MH be managed as a routine 6-week referral, with the complete patient journey—from initial referral to treatment—taking no longer than 6 months. It is important that patients are entered onto VR surgical lists so that there is no delay if ocriplasmin treatment is unsuccessful. Patients will need appropriate counselling about the expected outcomes and possible side effects of ocriplasmin treatment. One-year follow-up data should be collected by treatment centres in order to evaluate the new VMT service.

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Long-term Outcome of Idiopathic Macular Hole Surgery

Cited by 53 publications

References 37 publications

Impact of Internal Limiting Membrane Peeling on Macular Hole Reopening

Impact of Internal Limiting Membrane Peeling on Macular Hole Reopening

20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes

Redesigning services for the management of vitreomacular traction and macular hole

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