title: Re-operation of idiopathic full-thickness macular holes after initial surgery with internal limiting membrane peel.
abstract: OBJECTIVE
  A retrospective consecutive case series to evaluate the efficacy of re-operation in patients with persistent or recurrent idiopathic full-thickness macular hole after initial surgery with internal limiting membrane peel (ILM).
  
  
  METHODS
  491 patients underwent surgery for full-thickness macular hole from January 2004 to November 2007. Fifty-five patients either did not close or reopened during the follow-up period. Thirty patients with initial ILM peel underwent repeat surgery involving vitrectomy, enlargement of ILM rhexis and gas tamponade.
  
  
  RESULTS
  Anatomical closure rate was 88.8% for primary surgery and 46.7% (14/30) for re-operation. There was a statistically significant improvement in overall best corrected visual acuity (BCVA) from re-operation baseline BCVA (p=0.02) within 1 year. For holes that did not close after the second surgery, visual acuity did not worsen.
  
  
  CONCLUSIONS
  Re-operation has a reduced success rate of anatomical closure. However, BCVA is statistically significantly improved from re-operation baseline, so even though we cannot return vision to pre-pathological baseline, re-operation can improve on this new baseline.
authors.affiliation: Department of Family Medicine, University of Western Ontario, London, Ontario, Canada.
authors.forename: Mark J J
authors.initials: MJ
authors.lastname: D'Souza
authors.forename: Varun
authors.initials: V
authors.lastname: Chaudhary
authors.forename: Robert
authors.initials: R
authors.lastname: Devenyi
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kertes
authors.forename: Wai-Ching
authors.initials: WC
authors.lastname: Lam
mesh_terms: D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods