[Surgical treatment of lamellar macular hole].
OBJECTIVE
Vitrectomy and peeling in patients with lamellar macular hole was evaluated with regard to anatomical and functional outcome.


METHODS
In a retrospective study, 10 patients with lamellar macular hole underwent vitrectomy, membrane-peeling (epiretinal membrane [ERM] and internal limiting membrane [ILM]) and gas (n=9) or silicone oil (n=1) endotamponade. In most patients (n=9), cataract surgery was also performed. Pre- and postoperative ocular coherence tomography (OCT) findings, visual acuity (ETDRS), and Birkhäuser near visual acuity were evaluated.


RESULTS
Mean follow-up was 15+/-11 months after surgery with a minimum follow-up of 6 months. Best corrected visual acuity (BCVA) improved in all patients; the average BCVA gain was 3+/-2 lines. Preoperative mean BCVA was 0.35 (0.45+/-0.23logMAR), and postoperative BCVA was 0.64 (0.19+/-0.21logMAR). Eight of ten patients had a postoperative BCVA > or =20/40, and six patients had a postoperative BCVA > or =20/25. Mean near visual acuity was 0.5+/-0.26 (range 0.2-0.9). Postoperative OCT revealed a closed lamellar macular hole in six patients, with restored foveal contour in three of them. The other four patients showed a persistent inner retinal defect with an intact photoreceptor layer.


CONCLUSIONS
Surgical treatment including vitrectomy, ERM-ILM-peeling and endotamponade appears to benefit patients with lamellar macular hole. All patients improved functionally. Surgical treatment can close the lamellar macular hole and restore foveal architecture.
Engler
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C
Schwerpunkt Retinologie, Universitäts-Augenklinik, Im Neuenheimer Feld 400, 69120 Heidelberg, Deutschland.
Schaal
K B
KB
Höh
A E
AE
Dithmar
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S
D000368:Aged; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*