[Visual outcome of macular hole surgery with internal limiting membrane peeling].
OBJECTIVE
To evaluate the efficacy of the internal limiting membrane(ILM) peeling on macular hole surgery.


METHODS
A series of 102 patients(105 eyes) who underwent primary macular hole surgery between October 1994 and April 1999 was used for this retrospective study. The mean age was 65.6 +/- 7.1 years (mean +/- standard deviation). Of the study eyes, 34 eyes(32%) had a Stage II hole, 49 eyes(47%) had a Stage III hole, and 22 eyes(21%) had a Stage IV hole based on the Gass classification. Here we compared the surgical and visual outcome of the ILM peeling-treated group(treated group: 51 eyes) with those of ILM peeling-untreated group(untreated group: 54 eyes).


RESULTS
The hole closure rate after initial surgery was 98.0% in the treated group and 90.7% in the untreated group, and mean postoperative visual acuity, excluding cases where the hole was not closed by initial surgery, was 0.44 and 0.47, respectively. Visual improvement of 2 or more lines on Snellen chart was achieved in 84.3% and 57.4%(p < 0.01), and that of 4 or more lines in 54.9% and 25.9% (p < 0.01), respectively. Of the eyes with Stage II and III holes, visual outcome of the treated group was significantly better than that of the untreated group(p = 0.034, p = 0.037). In Stage IV, the initial closure rate of the treated group was significantly better than that of the untreated group(p = 0.02), but the visual outcome was not significantly different.


CONCLUSIONS
Vitreous surgery combined with ILM peeling for the management of idiopathic macular hole is effective not only on hole closure but also on visual recovery.
Yamanishi
S
S
Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime 791-0295, Japan.
Emi
K
K
Motokura
M
M
Oshima
Y
Y
Nakayama
M
M
Watanabe
M
M
D000368:Aged; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011379:Prognosis; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity; D014821:Vitrectomy