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INTERNAL LIMITING MEMBRANE PEELING AND AIR TAMPONADE FOR STAGE III AND STAGE IV IDIOPATHIC MACULAR HOLE

Yu, Yanping, MD*; Liang, Xida, MD*; Wang, Zengyi, MD*; Wang, Jing, MD*; Liu, Xinxin, MD; Chen, Jinqiu, MD*; Liu, Wu, MD, PhD*

doi: 10.1097/IAE.0000000000002340
Original Study: PDF Only

Purpose: To evaluate the effect of internal limiting membrane peeling and air tamponade for idiopathic macular hole, and explore reasons and interventions for persistent holes.

Methods: One hundred and thirty-five eyes with Stage III and IV idiopathic macular hole that underwent 23-gauge vitrectomy, internal limiting membrane peeling, and air tamponade were reviewed. Eyes with persistent holes underwent a second surgery. Outcome-related factors and interventions treating persistent holes were discussed.

Results: The initial closure (Type I) rate was 89.63% (121/135). Eyes that underwent the second surgery all obtained final closure (Type I). Diameter of macular hole was significantly smaller (P < 0.001) and duration of symptoms was significantly shorter (P = 0.017) in initially closed cases than in unclosed ones. Binary logistic regression indicated large diameter of macular hole as a risk factor for initial closure (P = 0.004). A cutoff value of 677 μm was provided by receiver operating characteristic curve to predict initial closure (P < 0.001). Best-corrected visual acuity of all individuals improved significantly (P < 0.001) from 20/154 to 20/40 (mean follow-up: 4.5 months).

Conclusion: Internal limiting membrane peeling and air tamponade for idiopathic macular hole provide satisfactory morphologic and functional outcomes. Large diameter of macular hole and long duration of symptoms are risk factors for initial closure. Proper second surgery can obtain satisfactory outcomes for persistent holes.

Internal limiting membrane peeling and air tamponade are effective for treating idiopathic macular hole, with initial and final closure rates of 89.63% and 100%, respectively. Large diameter of macular hole and long duration of symptoms are risk factors for initial closure. Proper second surgery can obtain satisfactory outcomes for persistent holes.

*Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Laboratory, Capital Medical University, Beijing, China; and

Department of Ophthalmology, Kailuan General Hospital, Hebei United University, Tangshan, China.

Reprint requests: Wu Liu, MD, PhD, Beijing Tongren Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing 100730, China; e-mail: wuliubj@sina.com

Presented at the Retina China 2018 Annual Meeting, China Centre for International Science and Technology Exchange, Chinese Ocular Fundus Disease Society, Chinese Journal of Ocular Fundus Diseases, Qingdao, Shandong Province, China, March 30, 2018.

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

© 2018 by Ophthalmic Communications Society, Inc.