J Korean Ophthalmol Soc.  2012 Sep;53(9):1291-1295. 10.3341/jkos.2012.53.9.1291.

Visual and Surgical Outcomes of Lamellar Macular Hole

• Choi WS
• Kim SW
• Lee WS
• Moon SJ
• Yoon HS

• KMID: 2216082
• DOI: http://doi.org/10.3341/jkos.2012.53.9.1291

Abstract

PURPOSE
To investigate the visual and anatomical results of surgical treatment for symptomatic lamellar macular hole.
METHODS
Ten eyes of ten patients with decreased visual acuity and lamellar macular hole were diagnosed using optical coherence tomography (OCT). Pars plana vitrectomy, epiretinal membrane removal, internal limiting membrane peeling, and gas tamponade (5 eyes) were performed for the treatment of lamellar hole. The resolution of the lamellar hole was assessed in relation to each OCT image at baseline.
RESULTS
The mean postoperative follow-up duration was 7.5 months, and best corrected visual acuity improved from log MAR 0.67 +/- 0.38 to log MAR 0.30 +/- 0.28. Central foveal thickness decreased from 441 +/- 184 microm to 291 +/- 64 microm. The OCT of all eyes demonstrated improvement in macular contour. However, retinal detachment in one eye occurred at two months after the operation and was reattached with gas tamponade and photocoagulation.
CONCLUSIONS
Vitrectomy, epiretinal membrane removal and internal limiting membrane peeling showed benefit in the treatment of symptomatic lamellar macular hole. However, large and prospective studies are necessary regarding the surgical indication, time and procedure for lamella macular hole.

Keyword

Epiretinal membrane removal; Internal limiting membrane peeling; Lamellar macular hole; Vitrectomy

MeSH Terms

Epiretinal Membrane
Eye
Follow-Up Studies
Humans
Membranes
Retinal Detachment
Retinal Perforations
Tomography, Optical Coherence
Visual Acuity
Vitrectomy

Figure

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  Figure 1 (A) Preoperative OCT images with visual acuity log MAR 0.40 and foveal thickness 357 µm. This image fulfills the criteria for OCT diagnosis of lamellar hole: (1) irregular foveal contour; (2) dehiscence in the inner fovea; (3) separation of the inner from the outer foveal retinal layers, leading to an intraretinal split; (4) absence of a full-thickness foveal defect. (B) OCT at 2 months after operation with visual acuity log MAR 0.22 and foveal thickness 331 µm.

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