Comparison of Surgical Outcomes Between Two Types of Lamellar Macular Holes
Received 17 September 2019
Accepted for publication 6 December 2019
Published 19 December 2019 Volume 2019:13 Pages 2541—2546
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Shumpei Obata, Yusuke Ichiyama, Masashi Kakinoki, Osamu Sawada, Yoshitsugu Saishin, Masahito Ohji
Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan
Correspondence: Shumpei Obata
Shiga University of Medical Science, 520 – 2192, Seta Tsukinowacho, Otsu City, Shiga, Japan
Purpose: The classification of lamellar macular holes (LMHs) into two subtypes has recently been proposed. However, the effectiveness of vitrectomy for treatment of each type of LMH is not well established. The goal of this study was to compare functional and anatomic changes after vitrectomy between eyes with degenerative LMH and those with tractional LMH.
Patients and methods: This was a retrospective analysis of the medical records of patients with LMH who underwent vitrectomy. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured preoperatively (baseline), as well as at 1, 3 and 12 months postoperatively. BCVA and CMT were compared between eyes with degenerative LMH and those with tractional LMH.
Results: Thirty-two eyes met the inclusion criteria. Thirteen eyes were diagnosed with degenerative LMH and 19 eyes were diagnosed with tractional LMH. Compared with baseline BCVA, postoperative BCVA improved significantly at 12 months postoperatively: from 0.33 to 0.12 logarithm of the minimum angle of resolution (logMAR) in eyes with degenerative LMH and from 0.30 to 0.12 logMAR in eyes with tractional LMH (p < 0.05 for both comparisons). BCVA at 12 months postoperatively did not significantly differ between the two groups. CMT decreased significantly from 419.4 μm at baseline to 364.2 μm at 12 months postoperatively in eyes with tractional LMH (p < 0.05); conversely, there was no significant difference in eyes with degenerative LMH (315.5 μm baseline to 314.9 μm at 12 months postoperatively; p > 0.05).
Conclusion: Vitrectomy improved BCVA in eyes with degenerative LMH as well as in eyes with tractional LMH. BCVA at 12 months postoperatively did not differ between the two groups.
Keywords: lamellar macular hole, surgery, visual acuity, ellipsoid zone
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