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HEMI-TEMPORAL INTERNAL LIMITING MEMBRANE PEELING IS AS EFFECTIVE AND SAFE AS CONVENTIONAL FULL PEELING FOR MACULAR HOLE SURGERY

Shiono, Akira, MD, PhD; Kogo, Jiro, MD, PhD; Sasaki, Hiroki, MD, PhD; Yomoda, Ryo, MD; Jujo, Tatsuya, MD; Tokuda, Naoto, MD, PhD; Kitaoka, Yasushi, MD, PhD; Takagi, Hitoshi, MD, PhD

doi: 10.1097/IAE.0000000000002215
Original Study: PDF Only

Purpose: To investigate the efficacy of hemi-temporal internal limiting membrane (ILM) peeling for idiopathic macular hole.

Methods: 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.

Results: 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).

Conclusion: 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: kogo@marianna-u.ac.jp

None of the authors have any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.