Novel surgical technique for macular holes with basal diameter >1000 μ

Closure rate of full-thickness macular holes (FTMHs) with basal diameter >1000 μ is known to be poor. Patients presenting with FTMH having a minimum basal diameter of >1000 μ without any coexistent retinal morbidity were offered vitrectomy, internal limiting membrane peeling, retinal massage,...

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Main Authors: Debdulal Chakraborty, Soumen Mondal, Sabyasachi Sengupta, Subhendu Boral, Arnab Das
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Taiwan Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/tjo.TJO-D-23-00025
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author Debdulal Chakraborty
Soumen Mondal
Sabyasachi Sengupta
Subhendu Boral
Arnab Das
author_facet Debdulal Chakraborty
Soumen Mondal
Sabyasachi Sengupta
Subhendu Boral
Arnab Das
author_sort Debdulal Chakraborty
collection DOAJ
description Closure rate of full-thickness macular holes (FTMHs) with basal diameter >1000 μ is known to be poor. Patients presenting with FTMH having a minimum basal diameter of >1000 μ without any coexistent retinal morbidity were offered vitrectomy, internal limiting membrane peeling, retinal massage, and aspiration of subretinal fluid from the MH. Visual acuity (VA) and spectral-domain optical coherence tomography (SD OCT) assessments were performed at baseline, week 1 after surgery and at postoperative months 1, 3, 6, and 12. VA, type of hole closure, presence of ellipsoid zone, and external limiting membrane defect were monitored. The primary endpoint was type 1 anatomical hole closure. Secondary outcome measure was a change in VA from baseline to 6-month follow-up and persistent hole closure at the final follow-up of 12 months. The mean age was 67.1 ± 9.1 years. Seven eyes were pseudophakic, and two underwent combined phacoemulsification with MH surgery. The mean minimum basal diameter of FTMH was 1162.4 ± 161 μ. The mean duration of visual loss was 11.3 ± 1.93 months. Type 1 closure of FTMH was seen in all patients on SD OCT, on the 7th postoperative day. The mean presenting VA was 1.06 ± 0.1 Logarithm of the minimum angle of resolution (logMAR). Best-corrected visual acuity improved to 0.91 ± 0.09 logMAR at 1-month follow-up (P = 0.005) (95% confidence interval [CI]: 0.061–0.251), 0.63 ± 0.1 logMAR (P < 0.001) (95% CI 0.339–0.527) at 3 months, and 0.55 ± 0.05 logMAR (P < 0.001) (95% CI 0.414–0.609) at 6 months. All holes were found closed at the final follow-up of 12 months. This novel technique can help achieve better outcomes and raise the primary anatomical success rate of FTMH with basal diameter >1000 μ.
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spelling doaj-art-7a750fba0a514e3da47418b9675858842025-01-14T15:51:48ZengWolters Kluwer Medknow PublicationsTaiwan Journal of Ophthalmology2211-50562211-50722024-12-0114460961310.4103/tjo.TJO-D-23-00025Novel surgical technique for macular holes with basal diameter >1000 μDebdulal ChakrabortySoumen MondalSabyasachi SenguptaSubhendu BoralArnab DasClosure rate of full-thickness macular holes (FTMHs) with basal diameter >1000 μ is known to be poor. Patients presenting with FTMH having a minimum basal diameter of >1000 μ without any coexistent retinal morbidity were offered vitrectomy, internal limiting membrane peeling, retinal massage, and aspiration of subretinal fluid from the MH. Visual acuity (VA) and spectral-domain optical coherence tomography (SD OCT) assessments were performed at baseline, week 1 after surgery and at postoperative months 1, 3, 6, and 12. VA, type of hole closure, presence of ellipsoid zone, and external limiting membrane defect were monitored. The primary endpoint was type 1 anatomical hole closure. Secondary outcome measure was a change in VA from baseline to 6-month follow-up and persistent hole closure at the final follow-up of 12 months. The mean age was 67.1 ± 9.1 years. Seven eyes were pseudophakic, and two underwent combined phacoemulsification with MH surgery. The mean minimum basal diameter of FTMH was 1162.4 ± 161 μ. The mean duration of visual loss was 11.3 ± 1.93 months. Type 1 closure of FTMH was seen in all patients on SD OCT, on the 7th postoperative day. The mean presenting VA was 1.06 ± 0.1 Logarithm of the minimum angle of resolution (logMAR). Best-corrected visual acuity improved to 0.91 ± 0.09 logMAR at 1-month follow-up (P = 0.005) (95% confidence interval [CI]: 0.061–0.251), 0.63 ± 0.1 logMAR (P < 0.001) (95% CI 0.339–0.527) at 3 months, and 0.55 ± 0.05 logMAR (P < 0.001) (95% CI 0.414–0.609) at 6 months. All holes were found closed at the final follow-up of 12 months. This novel technique can help achieve better outcomes and raise the primary anatomical success rate of FTMH with basal diameter >1000 μ.https://journals.lww.com/10.4103/tjo.TJO-D-23-00025internal limiting membrane peelingmacular holeretinal massage
spellingShingle Debdulal Chakraborty
Soumen Mondal
Sabyasachi Sengupta
Subhendu Boral
Arnab Das
Novel surgical technique for macular holes with basal diameter >1000 μ
Taiwan Journal of Ophthalmology
internal limiting membrane peeling
macular hole
retinal massage
title Novel surgical technique for macular holes with basal diameter >1000 μ
title_full Novel surgical technique for macular holes with basal diameter >1000 μ
title_fullStr Novel surgical technique for macular holes with basal diameter >1000 μ
title_full_unstemmed Novel surgical technique for macular holes with basal diameter >1000 μ
title_short Novel surgical technique for macular holes with basal diameter >1000 μ
title_sort novel surgical technique for macular holes with basal diameter 1000 μ
topic internal limiting membrane peeling
macular hole
retinal massage
url https://journals.lww.com/10.4103/tjo.TJO-D-23-00025
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AT subhenduboral novelsurgicaltechniqueformacularholeswithbasaldiameter1000m
AT arnabdas novelsurgicaltechniqueformacularholeswithbasaldiameter1000m