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ILM peeling aids in primary macular hole closure rates

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Internal limiting membrane peeling is associated with a statistically significant improvement in the rate of primary macular hole closure after a single operation, according to results of a mid-sized study.

Tom Sheidow, MD, FRCS(C), and colleagues with the University of Western Ontario evaluated 204 eyes of 197 patients underwent pars plana vitrectomy. Patients were divided into three groups: 97 patients underwent PPV with or without unilateral epiretinal membrane removal without ILM peeling, 44 patients with PPV and ILM peeling without indocyanine green (ICG) enhancement and 35 patients with ICG-assisted ILM peeling (group 1, 2 and 3 respectively).

Overall, 86.4% of the holes closed with one operation. Group 1 had a 77.3% closure rate; group 2 had a 97.7% closure rate and group 3 had a 97.1% closure rate. Visual acuity (VA) postoperatively was 20/50 or better in at least half the patients overall. At least 65% of the patients increased their VA by 2 or more lines from preoperative levels.

The study is published in the September issue of Ophthalmology.