Progressive changes of regional macular thickness after macular hole surgery with internal limiting membrane peeling

To determine the changes of regional macular thickness after successful macular hole surgery (MHS) with internal limiting membrane (ILM) peeling during a 24-month follow-up period.

In a prospective, interventional case study, the authors evaluated 24 eyes of 24 patients who underwent 23-gauge transconjunctival pars plana vitrectomy with triamcinolone-assisted ILM peeling to treat idiopathic macular hole. Examinations were performed before and 1, 2, 3, 6, 9, 12, and 24 months after surgery. Average regional macular thicknesses in the Early Treatment Diabetic Retinopathy Study sectors were measured by spectral-domain optical coherence tomography.

The four inner sectors showed a significant reduction in the average retinal thickness at 1 month after surgery (P ≤ 0.0001-0.020), and the thickness continued to decrease for 24 months except in the nasal sector. The four outer sectors had a significant increase at postoperative 1 month (P = 0.0003-0.029) and then progressively decreased during the postoperative 24 months. The postoperative regional macular thinning was statistically significant even between 12 and 24 months (P = 0.0007-0.026) in all sectors except in the inner nasal sector (P = 0.13). The postoperative percent reduction rate was significantly different among four inner sectors after postoperative 3 months (P = 0.0029-0.039) in the order of temporal > superior > inferior > nasal sectors.

These results suggest that a progressive macular thinning occurs for at least 2 years with different patterns of the changes in the macular regions after successful MHS with ILM peeling.