[Macular hole surgery with and without internal limiting membrane peeling]

Area of Science:

• Ophthalmology
• Retinal Surgery
• Macular Diseases

Background:

• Idiopathic macular holes are a common cause of visual impairment.
• Surgical repair is the primary treatment for macular holes.
• The role of internal limiting membrane (ILM) peeling in improving surgical outcomes remains debated.

Purpose of the Study:

• To evaluate the impact of internal limiting membrane (ILM) peeling on the anatomic and functional success of idiopathic macular hole surgery.
• To compare outcomes between patients who underwent ILM peeling and those who did not.

Main Methods:

• A comparative retrospective, nonrandomized study of 50 eyes from 48 patients with Stage III and IV idiopathic macular holes.
• Patients were divided into two groups: 25 eyes with ILM peeling (Group 1) and 25 eyes without ILM peeling (Group 2).
• All patients underwent surgery using the same technique; outcomes and complications were compared between groups.

Main Results:

• The overall anatomic success rate was 92%, with 100% success in the ILM peeling group versus 84% in the non-peeling group (p=0.018).
• Functional improvement (≥1 Snellen line) was observed in 80% of eyes with ILM peeling compared to 56% without (p=0.034).
• Complications included retinal detachment (2 in Group 1, 1 in Group 2), cataract, and retinal pigment epithelium changes.

Conclusions:

• Internal limiting membrane (ILM) peeling in macular hole surgery is associated with improved anatomic success rates.
• The procedure also demonstrates a trend towards better functional outcomes.
• ILM peeling did not significantly affect the final visual acuity in this study cohort.