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Internal limiting membrane peeling may aid repair of retinal detachment with macular hole

Am J Ophthalmol. 2011;152(5):815-819.

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Internal limiting membrane peeling may benefit primary repair of rhegmatogenous retinal detachment plus macular hole by improving macular hole closure rates, a study suggested.

The retrospective chart review analyzed 49 consecutive patients with retinal detachment caused by peripheral break and macular hole. All patients were treated with vitrectomy, and all except five had scleral buckling. Forty-three patients had internal limiting membrane peeling.

Retinal reattachment was achieved in 47 patients through only one procedure, with two patients requiring a second surgery. Final macular hole closure rate was 90.7% with membrane peeling and 33.3% without (P = .0041).

Of note, visual acuity outcomes were not as strong as those previously reported for successful primary macular hole repair. Mean final acuity was 20/120; it was 20/100 in cases in which the hole was closed. The study authors speculated that while stretching the macular hole during drainage may have negatively affected acuity results, the macula-off status of most patients had a strong negative effect on overall visual outcomes.