Lamellar macular holes: surgical outcome of 106 patients with long-term follow-up

Marco Coassin, Valentina Mastrofilippo, Jay M. Stewart, Andrea Fanti, Matteo Belpoliti, Luca Cimino, Alfonso Iovieno, Luigi Fontana

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine long-term results of vitrectomy for lamellar macular holes (LMH). To evaluate how the type of lamellar macular hole (tractional vs. degenerative) and the crystalline lens status might influence visual outcomes. Methods: We collected data from 106 patients with symptomatic lamellar macular hole that underwent pars plana vitrectomy with membranectomy and internal limiting membrane peeling. Best-corrected visual acuity (BCVA) and optical coherence tomography appearance were determined preoperatively and postoperatively. Results: Most of the lamellar holes were of tractional type (65%). Mean follow-up after surgery was 36 months. Mean BCVA increased from 20/50 to 20/43 at 6 months and 20/33 at last follow-up visit (p < 0.001). Vision improved in 74 (70%), remained stable in 11 (10%), and decreased in 21 (20%) eyes. Subgroup analysis showed that visual acuity significantly increased in the tractional but not in the degenerative forms of LMH. Thirteen eyes lost two or more ETDRS lines after surgery. Preoperative phakic/pseudophakic status influenced the functional outcomes. Conclusions: Surgery may be effective in some subsets of patients with lamellar macular hole, but postoperative visual loss is not uncommon and prospective controlled studies are warranted.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
DOIs
Publication statusAccepted/In press - May 21 2018

Keywords

  • Epiretinal membrane
  • Internal limiting membrane
  • Lamellar hole-associated epiretinal proliferation
  • Lamellar macular hole
  • Pars plana vitrectomy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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