J Korean Ophthalmol Soc.  2022 Oct;63(10):849-858. 10.3341/jkos.2022.63.10.849.

Long-term Outcomes of Vitrectomy with Internal Limiting Membrane Removal to Treat Macular Hole Retinal Detachment

• Jeon YJ
• Kim JW
• Kim CG
• Yoo SJ
• Kim HS
• Kim JY
• Kim JH

• KMID: 2534438
• DOI: http://doi.org/10.3341/jkos.2022.63.10.849

Abstract

Purpose
To evaluate the long-term clinical outcomes of vitrectomy with internal limiting membrane (ILM) removal for patients with macular hole retinal detachment (MHRD).
Methods
We retrospectively reviewed the medical records of patients with MHRD who underwent vitrectomy with ILM removal. The incidence of retinal re-attachment and MH closure at 1 month were calculated. Factors associated with RD recurrence were investigated. Visual acuity before surgery was compared to that at the final visit.
Results
Forty-two eyes were included; the mean follow-up period was 38.5 ± 19.1 months. Twenty-three eyes received gas injections and 19 silicone oil injections. Retinal re-attachment occurred in 41 (97.6%). Type 1 closure was noted in 21 eyes (51.2%) and type 2 in 20 (48.8%). Recurrent RD was noted in five eyes (14.6%) within 3 months of initial surgery. Type 2 closure was a risk factor for recurrence (p = 0.021). The logarithm of the minimum angle of resolution best-corrected visual acuity improved significantly from 1.79 ± 0.79 before surgery to 1.30 ± 0.75 after surgery (p < 0.001).
Conclusions
Retinal re-attachment was noted in most patients and the MH closed in approximately half of all patients after vitrectomy with ILM removal to treat MHRD. RD did not recur later than 3 months after initial surgery. Further efforts to increase the rate of type 1 closure are required.

Keyword

Macular hole; Retinal detachment; Vitrectomy