Relationship between Peeled Internal Limiting Membrane Area and Anatomic Outcomes following Macular Hole Surgery: A Quantitative Analysis

Abstract

Purpose. To quantitatively evaluate the effects of peeled internal limiting membrane (ILM) area and anatomic outcomes following macular hole surgery using spectral domain optical coherence tomography (SD-OCT). Methods. Forty-one eyes in 37 consecutive patients with idiopathic, Gass stage 3-4 macular hole (MH) were enrolled in this retrospective comparative study. All patients were divided into 2 groups according to anatomic success or failure. Basal MH diameter, peeled ILM area, and MH height were calculated using SD-OCT. Other prognostic parameters, including age, stage, preoperative BCVA, and symptom duration were also assessed. Results. Thirty-two cases were classified as anatomic success, and 9 cases were classified as anatomic failure. Peeled ILM area was significantly wider and MH basal diameter was significantly less in the anatomic success group (p = 0.024 and 0.032, resp.). Other parameters did not demonstrate statistical significance. Conclusion. The findings of the present study show that the peeled ILM area can affect the anatomic outcomes of MH surgery.

The impact of extent of internal limiting membrane peeling on anatomical outcomes of macular hole surgery: results of a 54‐week randomized clinical trial

“…Goker et al. () retrospectively analyzed 41 eyes with Gass stage 3–4 MH, which was divided into two groups based on anatomic success or failure. The multiple regression analysis showed an association between anatomical outcomes and two factors: basal MH diameter and peeled ILM range.…”

Langzeitergebnis nach autologer Membrana-limitans-interna-Lappenplastik bei nicht verschlossenem Makulaloch

“…Jedoch herrscht weiterhin die Meinung unter Netzhautchirurgen, dass je weiter initial gepeelt wird, desto besser ist die Verschlussrate. Dies mag auch teilweise richtig sein, wie die Vergleichsstudie von Goker et al gezeigt hat [9]. Nichtsdestotrotz sollte nicht über die Gefäßbögen hinaus gepeelt werden, da dies bei einer zukünftigen ILM-Lappenplastik doch erhebliche technische Schwierigkeiten bereiten kann [10].…”

Internal Limiting Membrane Peeling in Macular Hole Surgery; Why, When, and How?

“…88 Enlarging the ILM peel area can result in hole closure in failed cases undergoing revision surgery, and some authors have argued for large ILM PAs in all cases. 89 However, it is not at all clear what the optimum ILM peel size should be in any particular case.…”