Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole
Aim: The aim of this study was to assess the clinical profile and outcomes of the modified internal limiting membrane (ILM) peeling technique in patients with large macular holes (MHs) (400 μm). Methods: It is a retrospective case series where patients who underwent MH repair surgery by modified ILM...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
|
| Series: | Journal of Clinical Ophthalmology and Research |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jcor.jcor_181_24 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849696890973585408 |
|---|---|
| author | Amit S. Nene Sheetal Divate Onkar H. Pirdankar Pushpanjali Badole Pratik Shenoy Smitesh Shah |
| author_facet | Amit S. Nene Sheetal Divate Onkar H. Pirdankar Pushpanjali Badole Pratik Shenoy Smitesh Shah |
| author_sort | Amit S. Nene |
| collection | DOAJ |
| description | Aim:
The aim of this study was to assess the clinical profile and outcomes of the modified internal limiting membrane (ILM) peeling technique in patients with large macular holes (MHs) (400 μm).
Methods:
It is a retrospective case series where patients who underwent MH repair surgery by modified ILM peeling technique between January 2023 and June 2023 were considered. Subjects with MH minimum diameter >400 μ were included whereas subjects with associated retinal comorbidities such as diabetic retinopathy, retinal detachment, macular dystrophies, retinal degeneration, and cases with missing data were excluded. All surgeries were performed by a single surgeon. Various MH indices such as macular (MHI) and tractional hole index (THI) and diameter hole index were calculated and their association with postoperative best-corrected visual acuity (BCVA) was analyzed.
Results:
Eleven eyes of 11 patients with mean ± standard deviation age 66.36 ± 10.17 were included. Paired t-test revealed statistically significant improvement in post-BCVA (P = 0.006). Pearson correlation revealed a significant positive correlation between minimum diameter and postoperative BCVA (r = 0.76, P = 0.007) suggesting larger diameters were associated with poor visual acuity. MH inner diameter also showed a significant moderate positive correlation with postoperative BCVA (r = 0.61, P = 0.04). Furthermore, macular hole index and THI showed significant moderate (r = −0.68, P = 0.02) and strong (r = −0.82, P = 0.002) negative associations with postoperative BCVA, respectively, suggesting an increase in macular and THI associated with an improvement in postoperative BCVA.
Conclusion:
Managing larger MHs is challenging due to poor visual prognosis and lower anatomical success rate. The modified ILM peeling technique in our case series demonstrated improved anatomical and visual outcomes; however, prospective comparative study would give better insight. |
| format | Article |
| id | doaj-art-5e1b618c3f844c2caae3df0e8c03dcb0 |
| institution | DOAJ |
| issn | 2320-3897 2320-3900 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Clinical Ophthalmology and Research |
| spelling | doaj-art-5e1b618c3f844c2caae3df0e8c03dcb02025-08-20T03:19:20ZengWolters Kluwer Medknow PublicationsJournal of Clinical Ophthalmology and Research2320-38972320-39002025-04-0113218418710.4103/jcor.jcor_181_24Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular holeAmit S. NeneSheetal DivateOnkar H. PirdankarPushpanjali BadolePratik ShenoySmitesh ShahAim: The aim of this study was to assess the clinical profile and outcomes of the modified internal limiting membrane (ILM) peeling technique in patients with large macular holes (MHs) (400 μm). Methods: It is a retrospective case series where patients who underwent MH repair surgery by modified ILM peeling technique between January 2023 and June 2023 were considered. Subjects with MH minimum diameter >400 μ were included whereas subjects with associated retinal comorbidities such as diabetic retinopathy, retinal detachment, macular dystrophies, retinal degeneration, and cases with missing data were excluded. All surgeries were performed by a single surgeon. Various MH indices such as macular (MHI) and tractional hole index (THI) and diameter hole index were calculated and their association with postoperative best-corrected visual acuity (BCVA) was analyzed. Results: Eleven eyes of 11 patients with mean ± standard deviation age 66.36 ± 10.17 were included. Paired t-test revealed statistically significant improvement in post-BCVA (P = 0.006). Pearson correlation revealed a significant positive correlation between minimum diameter and postoperative BCVA (r = 0.76, P = 0.007) suggesting larger diameters were associated with poor visual acuity. MH inner diameter also showed a significant moderate positive correlation with postoperative BCVA (r = 0.61, P = 0.04). Furthermore, macular hole index and THI showed significant moderate (r = −0.68, P = 0.02) and strong (r = −0.82, P = 0.002) negative associations with postoperative BCVA, respectively, suggesting an increase in macular and THI associated with an improvement in postoperative BCVA. Conclusion: Managing larger MHs is challenging due to poor visual prognosis and lower anatomical success rate. The modified ILM peeling technique in our case series demonstrated improved anatomical and visual outcomes; however, prospective comparative study would give better insight.https://journals.lww.com/10.4103/jcor.jcor_181_24large macular holesmacular hole indicesmodified internal limiting membrane peeling technique |
| spellingShingle | Amit S. Nene Sheetal Divate Onkar H. Pirdankar Pushpanjali Badole Pratik Shenoy Smitesh Shah Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole Journal of Clinical Ophthalmology and Research large macular holes macular hole indices modified internal limiting membrane peeling technique |
| title | Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| title_full | Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| title_fullStr | Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| title_full_unstemmed | Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| title_short | Clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| title_sort | clinical profile and outcomes of modified internal limiting membrane peeling technique in patients with large macular hole |
| topic | large macular holes macular hole indices modified internal limiting membrane peeling technique |
| url | https://journals.lww.com/10.4103/jcor.jcor_181_24 |
| work_keys_str_mv | AT amitsnene clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole AT sheetaldivate clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole AT onkarhpirdankar clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole AT pushpanjalibadole clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole AT pratikshenoy clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole AT smiteshshah clinicalprofileandoutcomesofmodifiedinternallimitingmembranepeelingtechniqueinpatientswithlargemacularhole |