Modified vitrectomy for impending macular holes

We report a consecutive series of 13 eyes (11 patients) treated with pars plana vitrectomy, in which surgical manipulation of the prefoveal layer of cortical vitreous was avoided, for stage I (eight eyes) and stage II (five eyes) macular hole formation. Average follow up was 8.1 months (range, 2 to 13 months). There was no significant improvement in vision in the patients with stage II macular holes; however, vision in these patients stabilized and did not fall below 20/400. Visual acuity improved in seven of the eight patients with stage I holes. The results for both these groups achieved by our modified vitrectomy, which is relatively easy to perform and involves minimal intraoperative manipulation of the fovea, are consistent with those obtained by methods involving more aggressive cortical vitreous stripping of the fovea.