TY - JOUR
T1 - Internal limiting membrane peeling in macular hole surgery
AU - Smiddy, William E.
AU - Feuer, William
AU - Cordahi, Ghassan
PY - 2001/8/15
Y1 - 2001/8/15
N2 - Purpose: To evaluate prospectively the ability to peel epiretinal membranes and to correlate the degree of membrane peeling to anatomic success rates. Design: Consecutive, noncomparative, interventional case series. Participants: One hundred ninety-three patients. Methods: The extent of membrane peeling and other intraoperative features were correlated to endpoints. Main Outcome Measures: Anatomic success (inducing hole closure), visual acuity of 20/50 or better, and visual improvement of two or more Snellen lines. Results: One hundred ninety-three eyes were eligible for the study by virtue of having a minimum follow-up interval of 6 weeks. The overall anatomic success rate was 93% in these cases. There was a two-line or more improvement in 72%; 56% attained 20/50 or better visual acuity. The internal limiting membrane was peeled completely in 23%, partially in 43%, and not at all in 34%. The degree of internal limiting membrane peeling was not correlated with the duration of the hole or rate of two-line visual improvement, but was inversely correlated with the rate of anatomic success (P = 0.045). Final visual acuity was correlated with a better preoperative visual acuity, shorter preoperative duration of macular hole, and more complete internal limiting membrane peeling. Conclusions: Peeling of the internal limiting membrane is not essential for anatomic or visual success in macular hole surgery, but it may be a means to standardize inducement of the proper degree of gliosis. Excessive, unsuccessful attempts at internal limiting membrane peeling may decrease visual success. Techniques delivering a more reproducible, complete, atraumatic peeling of the internal limiting membrane should be studied.
AB - Purpose: To evaluate prospectively the ability to peel epiretinal membranes and to correlate the degree of membrane peeling to anatomic success rates. Design: Consecutive, noncomparative, interventional case series. Participants: One hundred ninety-three patients. Methods: The extent of membrane peeling and other intraoperative features were correlated to endpoints. Main Outcome Measures: Anatomic success (inducing hole closure), visual acuity of 20/50 or better, and visual improvement of two or more Snellen lines. Results: One hundred ninety-three eyes were eligible for the study by virtue of having a minimum follow-up interval of 6 weeks. The overall anatomic success rate was 93% in these cases. There was a two-line or more improvement in 72%; 56% attained 20/50 or better visual acuity. The internal limiting membrane was peeled completely in 23%, partially in 43%, and not at all in 34%. The degree of internal limiting membrane peeling was not correlated with the duration of the hole or rate of two-line visual improvement, but was inversely correlated with the rate of anatomic success (P = 0.045). Final visual acuity was correlated with a better preoperative visual acuity, shorter preoperative duration of macular hole, and more complete internal limiting membrane peeling. Conclusions: Peeling of the internal limiting membrane is not essential for anatomic or visual success in macular hole surgery, but it may be a means to standardize inducement of the proper degree of gliosis. Excessive, unsuccessful attempts at internal limiting membrane peeling may decrease visual success. Techniques delivering a more reproducible, complete, atraumatic peeling of the internal limiting membrane should be studied.
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U2 - 10.1016/S0161-6420(00)00645-X
DO - 10.1016/S0161-6420(00)00645-X
M3 - Article
C2 - 11470703
AN - SCOPUS:0034896158
VL - 108
SP - 1471
EP - 1476
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 8
ER -