OBJECTIVE: To report macular structure on optical coherence tomography (OCT) after lamellar macular hole surgery and its relationship with visual outcome. DESIGN: Retrospective interventional case series; private practice setting. PARTICIPANTS: Twelve patients diagnosed with a lamellar hole who had undergone vitrectomy and who had OCT scanning before and after surgery and at least 6 months follow-up were included. METHODS: Surgery consisted of 25 g vitrectomy, peeling of epiretinal and internal limiting membrane, fluid/air/gas exchange, and 2 weeks of face-down positioning. RESULTS: OCT showed an epiretinal membrane in all cases. After a mean follow-up of 16.7 months, VA improved by ≥2 lines in nine patients and remained stable in three. There was a complete closure of the lamellar hole in ten patients; in four a retinal pseudocyst was found during the healing process, resolving spontaneously in two and persisting in the other two after 8 and 9 months, respectively. Two patients developed a full-thickness macular hole that closed successfully after surgical repair. All patients had a VA ≥ 20/32 at the end of follow-up. CONCLUSION: Epiretinal membranes appear to have a role in the pathogenesis of lamellar macular holes. Vitrectomy is a useful technique to obtain closure of the lamellar hole and visual improvement. The presence of a retinal pseudocyst is a common feature during the healing process and is compatible with a favorable visual outcome. A full-thickness macular hole is a severe and not uncommon complication of this procedure.
OBJECTIVE: To report macular structure on optical coherence tomography (OCT) after lamellar macular hole surgery and its relationship with visual outcome. DESIGN: Retrospective interventional case series; private practice setting. PARTICIPANTS: Twelve patients diagnosed with a lamellar hole who had undergone vitrectomy and who had OCT scanning before and after surgery and at least 6 months follow-up were included. METHODS: Surgery consisted of 25 g vitrectomy, peeling of epiretinal and internal limiting membrane, fluid/air/gas exchange, and 2 weeks of face-down positioning. RESULTS: OCT showed an epiretinal membrane in all cases. After a mean follow-up of 16.7 months, VA improved by ≥2 lines in nine patients and remained stable in three. There was a complete closure of the lamellar hole in ten patients; in four a retinal pseudocyst was found during the healing process, resolving spontaneously in two and persisting in the other two after 8 and 9 months, respectively. Two patients developed a full-thickness macular hole that closed successfully after surgical repair. All patients had a VA ≥ 20/32 at the end of follow-up. CONCLUSION: Epiretinal membranes appear to have a role in the pathogenesis of lamellar macular holes. Vitrectomy is a useful technique to obtain closure of the lamellar hole and visual improvement. The presence of a retinal pseudocyst is a common feature during the healing process and is compatible with a favorable visual outcome. A full-thickness macular hole is a severe and not uncommon complication of this procedure.
Authors: K Purtskhvanidze; L Balken; T Hamann; L Wöster; C von der Burchard; J Roider; Felix Treumer Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-04-06 Impact factor: 3.117
Authors: Marco Coassin; Valentina Mastrofilippo; Jay M Stewart; Andrea Fanti; Matteo Belpoliti; Luca Cimino; Alfonso Iovieno; Luigi Fontana Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-05-21 Impact factor: 3.117