Outer Retinal Defects Represent a Normal Recovery Pathway Following Internal Limiting Membrane Peeling in Macular Hole Surgery

Ophthalmic Surg Lasers Imaging Retina. 2018 Sep 1;49(9):e1-e8. doi: 10.3928/23258160-20180907-01.

Abstract

Background and objective: To examine perioperative factors associated with the development of outer retinal defects (ORDs) following surgical repair of macular holes (MHs).

Patients and methods: An institutional review board-approved, retrospective, interventional cohort study was conducted. Patients who underwent MH repair during a 5-year period were identified. Statistical analysis was conducted to detect significant perioperative associations to ORD development.

Results: One hundred twenty-four eyes were included, and 54% developed an ORD following surgery. These defects correlated with lower preoperative stage (P = .0057), preoperative phakia (P = .036), and lack of prior macular surgery (P = .0016). Patients in the ORD group had significantly better preoperative and postoperative visual acuity (P = .031 and P = .0004, respectively), but there was no difference in change in acuity from preoperatively to 3 months postoperatively when compared with control patients (P = 42). The majority (89%) of ORDs resolved by 24 months postoperatively.

Conclusion: The development of ORDs appears to be correlated with several factors indicative of favorable overall eye health and less advanced pathology and may represent a normal state of recovery after MH repair with internal limiting membrane peeling. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e1-e8.].

MeSH terms

  • Aged
  • Basement Membrane / surgery*
  • Endotamponade / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Recovery of Function*
  • Retinal Perforations / diagnosis
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery*
  • Retinal Photoreceptor Cell Outer Segment / physiology*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy / methods*