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DIRECT MACULAR HOLE MANIPULATION RESULTS IN HIGH SUCCESS RATE IN SECONDARY MACULAR HOLE REPAIR
Etienne M Schönbach1, Darren K Knight1, Chris Y Wu2
1Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California.
Retina (Philadelphia, Pa.)
|February 2, 2023
Summary
Surgery for recurrent macular holes (MHs) shows good closure rates with techniques like tissue transplantation and MH manipulation. Repeat internal limiting membrane (ILM) peeling yields the poorest outcomes for these complex cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Hole Surgery
Background:
- Macular holes (MHs) can be challenging to treat, especially when recurrent or refractory to initial surgery.
- Understanding outcomes of secondary MH surgeries is crucial for managing complex cases.
Purpose of the Study:
- To evaluate the anatomical closure rates and functional outcomes of different surgical techniques for secondary macular hole repair.
- To assess the effectiveness of various surgical approaches in a real-world setting.
Main Methods:
- Retrospective review of 72 eyes undergoing secondary macular hole surgery.
- Analysis of closure rates and best-corrected visual acuity (BCVA) changes for techniques including tissue transplantation, internal limiting membrane (ILM) flaps, MH manipulation, and repeat ILM peeling.
Main Results:
- High closure rates were observed for tissue transplantation (89.3%), ILM flaps (77.3%), and MH manipulation (92.9%).
- Repeat ILM peeling showed significantly lower closure rates (12.5%) and poorer visual outcomes.
- Functional improvements in BCVA were noted for MH manipulation, tissue transplantation, and ILM flaps, while repeat ILM peeling resulted in vision worsening.
Conclusions:
- Secondary macular hole closure is achievable with various surgical methods, demonstrating acceptable anatomical success.
- Repeat internal limiting membrane peeling is linked to inferior closure rates and functional results compared to other techniques.
- Larger studies are needed to definitively differentiate the efficacy of these surgical approaches.
