Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes

Suthasinee Sinawat,1 Sukita Jumpawong,1 Tanapat Ratanapakorn,1 Chavakij Bhoomibunchoo,1 Yosanan Yospaiboon,1 Supat Sinawat2 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen Universi...

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Autores principales:	Sinawat S, Jumpawong S, Ratanapakorn T, Bhoomibunchoo C, Yospaiboon Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	full-thickness macular hole internal limiting membrane peeling conventional complete flap large macular hole Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/74a86fedb10449c2a99472f1e1305c3b
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spelling	oai:doaj.org-article:74a86fedb10449c2a99472f1e1305c3b2021-12-02T14:24:10ZEfficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes1177-5483https://doaj.org/article/74a86fedb10449c2a99472f1e1305c3b2021-02-01T00:00:00Zhttps://www.dovepress.com/efficacy-of-pars-plana-vitrectomy-with-internal-limiting-membrane-peel-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Suthasinee Sinawat,1 Sukita Jumpawong,1 Tanapat Ratanapakorn,1 Chavakij Bhoomibunchoo,1 Yosanan Yospaiboon,1 Supat Sinawat2 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Suthasinee Sinawat; Yosanan YospaiboonKKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mittraparb Highway, Khon Kaen, 40002, ThailandTel +66 43 348383Email ssuthasinee@kku.ac.th; yyosanan@gmail.comPurpose: To evaluate anatomical and visual outcomes of pars plana vitrectomy (PPV) with internal limiting membrane peeling (ILMP) in large idiopathic full-thickness macular holes (FTMH). Predictive factors also formed part of the study.Patients and Methods: A retrospective review of medical charts and optical coherence tomography images of patients with large idiopathic FTMH (≥ 400 μm) was conducted.Results: One hundred and fifty-eight eyes of 155 patients with a mean age of 62.94± 7.50 years were included in the study. Mean preoperative visual acuity (VA) was 1.26± 0.36 logMAR. Mean preoperative minimum linear diameter (MLD) and basal linear diameter (BLD) were 644.89± 136.85 μm and 1208.11± 307.14 μm, respectively. At 12 weeks postoperative follow-up, FTMH closure rate was 61.39% and mean postoperative BCVA was 0.92± 0.36 logMAR. Multivariate logistic regression analyses showed the anatomical outcome was significantly associated with BLD ≤ 1200 μm, preoperative vitreomacular interface (VMI) disorder and extended ILMP (a radius of 2 disc diameters), whereas only postoperative ellipsoid loss ≤ 500 μm was significantly associated with visual outcome. In subgroup analyses, the large FTMH group (400– 600 μm) had significantly better results in closure rate (70.97% vs 55.21%, P = 0.047) and visual results (P = 0.031) than the extra-large FTMH group (> 600 μm).Conclusion: PPV with conventional ILMP provided relatively low closure rate in large FTMH. Surgical success was significantly associated with BLD ≤ 1200 μm, no preoperative VMI abnormality, extended ILMP and postoperative ellipsoid defect ≤ 500 μm. Therefore, we suggest the extended ILMP if conventional ILMP technique is used. The large FTMH group had significantly better surgical outcomes than the extra-large group, so there is a need for reclassification of large FTMH.Keywords: full-thickness macular hole, internal limiting membrane peeling, conventional, complete flap, large macular holeSinawat SJumpawong SRatanapakorn TBhoomibunchoo CYospaiboon YSinawat SDove Medical Pressarticlefull-thickness macular holeinternal limiting membrane peelingconventionalcomplete flaplarge macular holeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 521-529 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	full-thickness macular hole internal limiting membrane peeling conventional complete flap large macular hole Ophthalmology RE1-994
spellingShingle	full-thickness macular hole internal limiting membrane peeling conventional complete flap large macular hole Ophthalmology RE1-994 Sinawat S Jumpawong S Ratanapakorn T Bhoomibunchoo C Yospaiboon Y Sinawat S Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
description	Suthasinee Sinawat,1 Sukita Jumpawong,1 Tanapat Ratanapakorn,1 Chavakij Bhoomibunchoo,1 Yosanan Yospaiboon,1 Supat Sinawat2 1KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Suthasinee Sinawat; Yosanan YospaiboonKKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mittraparb Highway, Khon Kaen, 40002, ThailandTel +66 43 348383Email ssuthasinee@kku.ac.th; yyosanan@gmail.comPurpose: To evaluate anatomical and visual outcomes of pars plana vitrectomy (PPV) with internal limiting membrane peeling (ILMP) in large idiopathic full-thickness macular holes (FTMH). Predictive factors also formed part of the study.Patients and Methods: A retrospective review of medical charts and optical coherence tomography images of patients with large idiopathic FTMH (≥ 400 μm) was conducted.Results: One hundred and fifty-eight eyes of 155 patients with a mean age of 62.94± 7.50 years were included in the study. Mean preoperative visual acuity (VA) was 1.26± 0.36 logMAR. Mean preoperative minimum linear diameter (MLD) and basal linear diameter (BLD) were 644.89± 136.85 μm and 1208.11± 307.14 μm, respectively. At 12 weeks postoperative follow-up, FTMH closure rate was 61.39% and mean postoperative BCVA was 0.92± 0.36 logMAR. Multivariate logistic regression analyses showed the anatomical outcome was significantly associated with BLD ≤ 1200 μm, preoperative vitreomacular interface (VMI) disorder and extended ILMP (a radius of 2 disc diameters), whereas only postoperative ellipsoid loss ≤ 500 μm was significantly associated with visual outcome. In subgroup analyses, the large FTMH group (400– 600 μm) had significantly better results in closure rate (70.97% vs 55.21%, P = 0.047) and visual results (P = 0.031) than the extra-large FTMH group (> 600 μm).Conclusion: PPV with conventional ILMP provided relatively low closure rate in large FTMH. Surgical success was significantly associated with BLD ≤ 1200 μm, no preoperative VMI abnormality, extended ILMP and postoperative ellipsoid defect ≤ 500 μm. Therefore, we suggest the extended ILMP if conventional ILMP technique is used. The large FTMH group had significantly better surgical outcomes than the extra-large group, so there is a need for reclassification of large FTMH.Keywords: full-thickness macular hole, internal limiting membrane peeling, conventional, complete flap, large macular hole
format	article
author	Sinawat S Jumpawong S Ratanapakorn T Bhoomibunchoo C Yospaiboon Y Sinawat S
author_facet	Sinawat S Jumpawong S Ratanapakorn T Bhoomibunchoo C Yospaiboon Y Sinawat S
author_sort	Sinawat S
title	Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
title_short	Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
title_full	Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
title_fullStr	Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
title_full_unstemmed	Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes
title_sort	efficacy of pars plana vitrectomy with internal limiting membrane peeling for treatment of large idiopathic full-thickness macular holes
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/74a86fedb10449c2a99472f1e1305c3b
work_keys_str_mv	AT sinawats efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes AT jumpawongs efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes AT ratanapakornt efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes AT bhoomibunchooc efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes AT yospaiboony efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes AT sinawats efficacyofparsplanavitrectomywithinternallimitingmembranepeelingfortreatmentoflargeidiopathicfullthicknessmacularholes
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Efficacy of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment of Large Idiopathic Full-Thickness Macular Holes

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