Related Experiment Videos
Combined versus Sequential Surgery in Lamellar Macular Holes: A Multicenter Observational Study
Santiago López Arbués1, Susana Gómez Rivera1, Ibai Tamayo Rodríguez2
1Department of Ophthalmology, Hospital Universitario de Navarra, Pamplona, Spain.
Clinical Ophthalmology (Auckland, N.Z.)
|May 11, 2026
Summary
Pars plana vitrectomy (PPV) for lamellar macular hole (LMH) improves vision. Combined and sequential surgical approaches yield similar visual outcomes, with baseline visual acuity being the primary predictor of success.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Microsurgery
Background:
- Lamellar macular hole (LMH) is a condition affecting central vision.
- Pars plana vitrectomy (PPV) is a surgical technique used to treat various retinal conditions.
- Understanding the optimal surgical strategy for LMH is crucial for visual recovery.
Purpose of the Study:
- To compare 1-year best-corrected visual acuity (BCVA) after PPV for LMH between combined phacovitrectomy and sequential surgical strategies.
- To identify factors influencing postoperative visual outcomes in LMH patients.
Main Methods:
- A multicenter observational study included adults with OCT-confirmed LMH undergoing PPV.
- Surgical sequences were categorized as combined or sequential.
- LMH subtypes (tractional, mixed, degenerative) were classified via OCT.
- BCVA was measured preoperatively and at 1 year.
Main Results:
- No significant difference in 1-year BCVA was found between combined and sequential surgery (p=0.939) or among LMH subtypes.
- Overall BCVA improved from 0.4 to 0.2 logMAR at 1 year.
- Baseline BCVA was the sole independent predictor of 1-year BCVA (β=0.60, p<0.001).
Conclusions:
- PPV for LMH leads to significant visual improvement at 1 year.
- Neither combined nor sequential surgical approaches demonstrated superior visual outcomes.
- Baseline BCVA is the key determinant of 1-year visual results, guiding personalized surgical decisions.
