Macular hole closure rate better with ILM peeling vs. PPV alone
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Pars plana vitrectomy with internal limiting membrane peeling for macular hole closure is better than pars plana vitrectomy without internal limiting membrane peeling, according to a study.
Prashant Bawankule, MS, of Sarakshi Netralaya in Nagpur, India, presented the results of the prospective, nonrandomized, interventional study at the American Society of Retina Specialists meeting. The study included 23 patients with rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR) who underwent treatment for concomitant macular holes with pars plana vitrectomy (PPV).
Patients were divided into three groups: those treated with PPV with internal limiting membrane (ILM) peeling (10 patients), those treated with PPV without ILM peeling (seven patients) and those treated with PPV using inverted ILM peel (six patients).
No patients in the inverted flap group experienced recurrent retinal detachment compared with one patient in the ILM peel group and three patients in the no-peel group. No patients who underwent either peel technique experienced macular hole reopening compared with one patient in the no-peel group. One patient in the ILM peel group experienced PVR, as did the patient in the no-peel group who experienced macular hole reopening.
Visual acuity gain was better in the ILM peel groups vs. the no-peel group, according to Bawankule.
“Though challenging and not free of complications, inverted ILM peel can be considered as a procedure of choice in these cases,” he said.
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Bawankule P, et al. Comparative study of success of various techniques of ILM peel in management of RRD with PVR & concomitant macular hole. Presented at: American Society of Retina Specialists annual meeting; July 17-20, 2024; Stockholm.
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