Umberto Lorenzi1,2, Joel Mehech1, Tommaso Caporossi3,4, Mario R Romano5, Rocco De Fazio6, Eric Parrat2,7, Frédéric Matonti2,8,9,10, Paolo Mora11. 1. Ophthalmology Unit, Centre Hospitalier Universitaire Charles-Nicolle, Rouen, France. 2. P 1.5 Group, 80, allée des Ormes, 06250, Mougins, France. 3. Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 4. Catholic University "Sacro Cuore", Rome, Italy. 5. Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy. 6. Ophthalmology Unit, Ospedale Santa Maria della Scaletta, Imola, Italy. 7. Clinique Des Eaux Claires, Baie-Mahault, Guadeloupe, France. 8. Centre Monticelli Paradis, Marseille, France. 9. Institut de Neuroscience de La Timone, Aix-Marseille University, Marseille, France. 10. Clinique Juge, Groupe Almaviva Santé, Marseille, France. 11. Ophthalmology Unit, University Hospital of Parma, 43126, Parma, PR, Italy. paolo.mora@unipr.it.
Abstract
PURPOSE: To evaluate the surgical management, outcomes and prognostic factors of full thickness macular holes without residual internal limiting membrane (NO-ILM FTMHs). METHODS: We performed a multicenter, retrospective study of 116 NO-ILM FTMHs. Human amniotic membrane (hAM) plug, autologous ILM free flap transplantation (AILMT), and autologous retinal graft transplantation (ART) were performed in 58, 48, and 10 patients, respectively. Data were collected before and up to 12 months after surgery. The primary outcomes were hole closure and final best-corrected visual acuity (BCVA). RESULTS: The final BCVA (0.78 ± 0.51 logMAR) was significantly better than and correlated with the initial BCVA (p < 0.0001 and p = 0.004, respectively). Hole closure was achieved in 92% of eyes. The minimum FTMH diameter was wider and final BCVA was lower in the ART group than in the other groups (p < 0.003 and p < 0.001, respectively). FTMHs with diameter > 680 μm had a higher closure rate with hAM than with AILMT (p = 0.02). CONCLUSIONS: AILMT and hAM were the most frequently performed surgeries with both high closure rate and significant functional improvement. Preoperative BCVA was correlated with final BCVA. The minimum FTMH diameter may guide the treatment choice.
PURPOSE: To evaluate the surgical management, outcomes and prognostic factors of full thickness macular holes without residual internal limiting membrane (NO-ILM FTMHs). METHODS: We performed a multicenter, retrospective study of 116 NO-ILM FTMHs. Human amniotic membrane (hAM) plug, autologous ILM free flap transplantation (AILMT), and autologous retinal graft transplantation (ART) were performed in 58, 48, and 10 patients, respectively. Data were collected before and up to 12 months after surgery. The primary outcomes were hole closure and final best-corrected visual acuity (BCVA). RESULTS: The final BCVA (0.78 ± 0.51 logMAR) was significantly better than and correlated with the initial BCVA (p < 0.0001 and p = 0.004, respectively). Hole closure was achieved in 92% of eyes. The minimum FTMH diameter was wider and final BCVA was lower in the ART group than in the other groups (p < 0.003 and p < 0.001, respectively). FTMHs with diameter > 680 μm had a higher closure rate with hAM than with AILMT (p = 0.02). CONCLUSIONS: AILMT and hAM were the most frequently performed surgeries with both high closure rate and significant functional improvement. Preoperative BCVA was correlated with final BCVA. The minimum FTMH diameter may guide the treatment choice.
Authors: Michael S Ip; Brad J Baker; Jay S Duker; Elias Reichel; Caroline R Baumal; Ronald Gangnon; Carmen A Puliafito Journal: Arch Ophthalmol Date: 2002-01