Surgical treatment of lamellar macular hole secondary to epiretinal membrane

Abstract

In LMH secondary to ERM with significant visual decrease, ERM and ILM peeling may improve BCVA. Postoperative gas tamponade is associated with better restoration of macular configuration. Final BCVA is related to an intact photoreceptor IS-OS junction rather than to the normalization of the macular contour.

Role of Lamellar Hole–Associated Epiretinal Proliferation in Lamellar Macular Holes

“…This finding is important in light of the fact that recommendations for surgical repair of eyes with LMHs are controversial, with some authors reporting good surgical outcomes and others documenting worsening of anatomic features and VA after surgery. 1,3,7,10,11,[21][22][23] The limitations of this study include its retrospective nature, the relatively restricted number of patients, and the variable duration of follow-up.…”

Surgical Outcome after Lamellar Macular Hole Associated with Epiretinal Membrane

“…Anatomically, most of the patients (92%) had an improvement of the LH contour with reduction of IRF. Not a single patient had disruption of the inner segment-outer segment junction, which is more important for the final vision rather than normalization of the macular contour [17,20]. With respect to the short-term follow-up, we expect further BCVA increase in the long term.…”

“…Surgical treatment of LHEP remains controversial as various studies have shown different outcomes [8][9][10][11][12][13][14][15][16][17]. In addition, many vitreoretinal surgeons hesitate to perform vitrectomy because of the fear to induce an iatrogenic macular hole or defects in the inner segment-outer segment junction [15][16][17].…”

“…In addition, many vitreoretinal surgeons hesitate to perform vitrectomy because of the fear to induce an iatrogenic macular hole or defects in the inner segment-outer segment junction [15][16][17]. Not entirely unfounded, for example, in the small study of Witkin et al [15] up to 50% of patients developed an iatrogenic macular hole postoperatively.…”

“…Surgical treatment of LH still remains controversial. Some authors believe that there is no proof that surgical intervention is helpful [8][9][10][11][12], whereas other studies found vitrectomy with epiretinal membrane removal to be beneficial regarding visual acuity and foveal optical coherence tomography (OCT) appearance [11][12][13][14][15][16][17].…”