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Foveal sparing internal limiting membrane peeling for idiopathic macular holes: effects on anatomical restoration of the fovea and visual function.

Murphy, Declan C, Fostier, Will, Rees, Jon and Steel, David H (2019) Foveal sparing internal limiting membrane peeling for idiopathic macular holes: effects on anatomical restoration of the fovea and visual function. Retina. ISSN 1539-2864

Item Type: Article

Abstract

Muller cells seem to be important in maintaining foveal morphology through connections between their foot processes and the internal limiting membrane (ILM). Internal limiting membrane peeling causes Muller cell trauma. We hypothesized that leaving a rim of unpeeled ILM around idiopathic macular holes undergoing vitrectomy surgery would improve postoperative foveal morphology and vision. Prospective pilot study of fovea-sparing ILM peeling in a consecutive cohort of patients with macular holes over a 12-month period. Spectral-domain optical coherence tomography and Early Treatment Diabetic Retinopathy Study letters best-corrected visual acuity were assessed preoperatively and postoperatively, and foveal morphology and metamorphopsia postoperatively. The foveal sparing group was compared with a second consecutive cohort who received standard ILM peeling (control group). Thirty-four eyes of 34 patients were included in each group. Groups showed no significant preoperative differences. 34/34 holes were successfully closed with surgery in the foveal sparing group and 32/34 in the control group. The foveal sparing group showed better postoperative best-corrected visual acuity (67.7 vs. 63.8, P = 0.003) and best-corrected visual acuity improvement (25.1 vs. 20.2, P = 0.03). The foveal sparing group demonstrated thicker minimum foveal thickness (211 vs. 173 μm, P = 0.002) and less steep foveal depression (158 vs. 149, P = 0.002). Preserving nonpeeled ILM around macular holes resulted in a high closure rate, improved foveal morphology, and better postoperative best-corrected visual acuity. An appropriately powered randomized controlled study is warranted.

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Identifiers

Item ID: 11425
Identification Number: https://doi.org/10.1097/IAE.0000000000002724
ISSN: 1539-2864
URI: http://sure.sunderland.ac.uk/id/eprint/11425

Users with ORCIDS

ORCID for Jon Rees: ORCID iD orcid.org/0000-0002-3295-244X

Catalogue record

Date Deposited: 26 Feb 2020 11:46
Last Modified: 05 Aug 2023 03:30

Contributors

Author: Jon Rees ORCID iD
Author: Declan C Murphy
Author: Will Fostier
Author: David H Steel

University Divisions

Faculty of Health Sciences and Wellbeing > School of Psychology

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