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Choi, Kim, Lee, Moon, and Yoon: Visual and Surgical Outcomes of Lamellar Macular Hole
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1291-1295.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1291

Visual and Surgical Outcomes of Lamellar Macular Hole

Woo Seok Choi, MD, Sang Won Kim, MD, Woo Seok Lee, MD, Sang Jeong Moon, MD, Hee Seong Yoon, MD

Sungmo Eye Hospital, Busan, Korea.

Address reprint requests to Hee Seong Yoon, MD. Sungmo Eye Hospital, #409-1 Haeundae-ro, Haeundae-gu, Busan 612-823, Korea. Tel: 82-51-743-0775, Fax: 82-51-743-0776, heesyoon@dreamwiz.com

Received 11 July 2011       Accepted 12 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To investigate the visual and anatomical results of surgical treatment for symptomatic lamellar macular hole.

Methods

Ten eyes of ten patients with decreased visual acuity and lamellar macular hole were diagnosed using optical coherence tomography (OCT). Pars plana vitrectomy, epiretinal membrane removal, internal limiting membrane peeling, and gas tamponade (5 eyes) were performed for the treatment of lamellar hole. The resolution of the lamellar hole was assessed in relation to each OCT image at baseline.

Results

The mean postoperative follow-up duration was 7.5 months, and best corrected visual acuity improved from log MAR 0.67 ± 0.38 to log MAR 0.30 ± 0.28. Central foveal thickness decreased from 441 ± 184 µm to 291 ± 64 µm. The OCT of all eyes demonstrated improvement in macular contour. However, retinal detachment in one eye occurred at two months after the operation and was reattached with gas tamponade and photocoagulation.

Conclusions

Vitrectomy, epiretinal membrane removal and internal limiting membrane peeling showed benefit in the treatment of symptomatic lamellar macular hole. However, large and prospective studies are necessary regarding the surgical indication, time and procedure for lamella macular hole.

Keywords: Epiretinal membrane removal, Internal limiting membrane peeling, Lamellar macular hole, Vitrectomy

Figures and Tables

Figure 1
(A) Preoperative OCT images with visual acuity log MAR 0.40 and foveal thickness 357 µm. This image fulfills the criteria for OCT diagnosis of lamellar hole: (1) irregular foveal contour; (2) dehiscence in the inner fovea; (3) separation of the inner from the outer foveal retinal layers, leading to an intraretinal split; (4) absence of a full-thickness foveal defect. (B) OCT at 2 months after operation with visual acuity log MAR 0.22 and foveal thickness 331 µm.
jkos-53-1291-g001
Table 1
Characteristics of patients before and after operation
jkos-53-1291-i001

VA = visual acuity; CMT = central macular thickness; PPV = Pars plana vitrectomy; memb = epiretinal membrane peeling; ILM = internal limit membrane peeling.

Table 2
Summary of preoperative and postoperative information
jkos-53-1291-i002

Values are presented as mean ± SD or number.

VA = visual acuity; CMT = central macular thickness.

*p = 0.008; †p = 0.005.

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