To investigate the efficacy of hemi-temporal internal limiting membrane (ILM) peeling for idiopathic macular hole.
The medical records of patients with macular holes who had undergone vitrectomy with ILM peeling were studied. Forty-two eyes with macular hole were divided into 2 groups based on surgical procedure (hemi-temporal ILM peeling [hemi group]: 15 eyes; 360° ILM peeling [360° group]: 27 eyes). The closure rates and distances between the optic disc and the intersection of two retinal vessels most closely located nasally or temporally to the macular hole were compared.
The primary closure rates were not significantly different between the two groups (hemi group: 93.3%; 360° group: 92.5%, P = 0.92). The temporal retinal vessels in the hemi group were displaced 120.5 ± 102.0 µm toward the optic disc at 1 week postoperatively, which did not differ significantly from the 360° group (136.1 ± 106.1 µm) (P = 0.107). However, the nasal retinal vessels in the hemi group were displaced by 42.4 ± 42.9 µm at 1 week postoperatively, which was significantly less than the 90.1 ± 77.3 µm displacement seen in the 360° group (P = 0.040).
Hemi-temporal ILM peeling may be preferable to 360° ILM peeling because of less displacement of the retina and greater safety.
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Hemi-temporal internal limiting membrane peeling may be preferable to 360° internal limiting membrane peeling because of less displacement of the retinal vessels toward the nasal side and may have a potential advantage for hole closure without the potential for central papillomacular bundle damage.
Department of Ophthalmology, St. Marianna University School of Medicine, Kanagawa, Japan.
Reprint requests: Jiro Kogo, MD, PhD, Department of Ophthalmology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.