Purpose: To compare vitrectomy with and without internal limiting membrane (ILM) peeling in small idiopathic macular holes. Methods: Retrospective multicentre study including consecutive eyes with ≤250 μm idiopathic macular hole treated with vitrectomy. The primary outcome was hole closure rate. Best-corrected visual acuity (BCVA) change, closure patterns on optical coherence tomography, rates of external limiting membrane (ELM) and ellipsoid zone (EZ) recovery, and rate of complications were also investigated. Results: In total, 693 eyes were included. Hole closure rate was 98% in the peeling and 85% in the no-peeling group (p < 0.001). At 12 months, mean BCVA change was 0.38 ± 0.22 logMAR in the peeling and 0.45 ± 0.21 logMAR in the no-peeling group (p = 0.02); 66% versus 80% of eyes had a U-shaped morphology, respectively; EZ recovery rate was 75% and 93%, respectively (p = 0.02). In the no-peeling group, eyes with a vitreomacular traction (VMT) showed a 96% closure rate, comparable to the peeling group (p = 0.40). The incidence of adverse events was similar except for dissociated optic nerve fibre layer (55% in the peeling vs. 9% in the no-peeling group, p < 0.001). Conclusions: In small idiopathic macular holes, ILM peeling provides a higher closure rate compared to no-peeling; however, if a VMT is present closure rates are comparable. In closed macular holes, the no-peeling technique provides advantages in terms of visual outcome and anatomical recovery.
Vitrectomy in Small idiopathic MAcuLar hoLe (SMALL) study: Internal limiting membrane peeling versus no peeling / Marolo, P.; Caselgrandi, P.; Fallico, M.; Parisi, G.; Borrelli, E.; Ricardi, F.; Gelormini, F.; Ceroni, L.; Reibaldi, M.; Ferrari, T. M.; Lorusso, M.; Primavera, V.; Giuliani, G.; Mariotti, C.; Lupidi, M.; Ventre, L.; Pintore, G.; Motta, L.; Ripa, M.; Boscia, F.; Boscia, G.; Romano, M. R.; Ferrara, M.; Miroslav, K.; Marchina, D.; Parolini, B.; Peiretti, E.; Marchiori, V.; Dell'Omo, R.; Affatato, M.; Avitabile, T.; Russo, A.; Longo, A.; Scorcia, V.; Carnevali, A.; Mastropasqua, R.; Toto, L.; Vaiano, A. S.; Merli, R.; Mura, M.; Pellegrini, M.; Giansanti, F.; Nicolosi, C.; Badino, M.; Lavorante, N. P.; Sandinha, M. T.; D'Alterio, F. M.; Toro, M. D.; Rejdak, R.; Chelazzi, P.; Azzolini, C.; Viola, F.; Dona, C.; Cereda, M. G.; Casaluci, M.; Codenotti, M.; Iuliano, L.; Pertile, G.; Sindaco, D.; De Cilla, S.; Muraca, A.; Bonfiglio, V. M. E.; Vadala, M.; La Mantia, A.; Randazzo, V.; Fiore, T.; Tosi, G.; Frisina, R.; Angeli, C.; Coassin, M.; Laborante, M.; Rossi, T.; Cosimi, P.; Rizzo, S.; Carla, M. M.; Gharbiya, M.; Albanese, G. M.; Caretti, L.; Angelini, E.; Tosi, G. M.; Bacci, T.; Steel, D. H.; Dervenis, N.; Vagiakis, I.; Tognetto, D.; Pastore, M. R.; Faraldi, F.; Lavia, C. A.; Lanzetta, P.; Veritti, D.; Rubinato, L.; Radice, P.; Govetto, A.. - In: ACTA OPHTHALMOLOGICA. - ISSN 1755-3768. - (2024). [10.1111/aos.16778]
Vitrectomy in Small idiopathic MAcuLar hoLe (SMALL) study: Internal limiting membrane peeling versus no peeling
Lupidi M.Membro del Collaboration Group
;Ventre L.Membro del Collaboration Group
;Motta L.Membro del Collaboration Group
;Romano M. R.Membro del Collaboration Group
;Mastropasqua R.Membro del Collaboration Group
;Badino M.Membro del Collaboration Group
;Casaluci M.;Angeli C.Membro del Collaboration Group
;Gharbiya M.Membro del Collaboration Group
;Albanese G. M.Membro del Collaboration Group
;
2024
Abstract
Purpose: To compare vitrectomy with and without internal limiting membrane (ILM) peeling in small idiopathic macular holes. Methods: Retrospective multicentre study including consecutive eyes with ≤250 μm idiopathic macular hole treated with vitrectomy. The primary outcome was hole closure rate. Best-corrected visual acuity (BCVA) change, closure patterns on optical coherence tomography, rates of external limiting membrane (ELM) and ellipsoid zone (EZ) recovery, and rate of complications were also investigated. Results: In total, 693 eyes were included. Hole closure rate was 98% in the peeling and 85% in the no-peeling group (p < 0.001). At 12 months, mean BCVA change was 0.38 ± 0.22 logMAR in the peeling and 0.45 ± 0.21 logMAR in the no-peeling group (p = 0.02); 66% versus 80% of eyes had a U-shaped morphology, respectively; EZ recovery rate was 75% and 93%, respectively (p = 0.02). In the no-peeling group, eyes with a vitreomacular traction (VMT) showed a 96% closure rate, comparable to the peeling group (p = 0.40). The incidence of adverse events was similar except for dissociated optic nerve fibre layer (55% in the peeling vs. 9% in the no-peeling group, p < 0.001). Conclusions: In small idiopathic macular holes, ILM peeling provides a higher closure rate compared to no-peeling; however, if a VMT is present closure rates are comparable. In closed macular holes, the no-peeling technique provides advantages in terms of visual outcome and anatomical recovery.| File | Dimensione | Formato | |
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