Clinical and functional results of idiopathic macular holes treatment with foveal internal limiting membrane sparing

Abstract

Purpose. To evaluate clinical and functional results of originally developed technique of preserving foveal internal limiting membrane (ILM) in the surgical treatment of idiopathic macular holes (IMH) with a minimum diameter of less than 500μm in comparison with standard technique that does not require preservation of the foveal ILM. Material and methods. This study included 75 patients (75 eyes) with IMH with a minimum diameter of less than 500μm and complaints manifestation of no more than 12 months. 35 patients (35 eyes, control group) were operated using standard technique. In 40 patients (40 eyes, main group) surgical intervention was performed using originally developed technique of foveal ILM sparing. Results. The anatomical closure of the IMH after surgery was obtained in all 75 patients. In two patients (one in the main and one in the control groups) within 1 month after surgery, a recurrence of IMH developed. All functional results in the main group had significant positive dynamics if compared with control group: increase in central and general light sensitivity, spatial contrast sensitivity, low-contrast visual acuity without and with glare. The increase in the best corrected visual acuity was also greater in the main group, but the difference from the control group was not significant. Conclusion. Originally developed technique of preserving the foveal ILM is highly effective in the surgical treatment of IMH with a minimum diameter of less than 500μm. In comparison with the standard technique of surgery with the removal of the ILM, this technique allows to achieve higher functional results with an equal frequency of positive anatomical outcomes. Key words: idiopathic macular hole, ILM peeling, surgical treatment, foveal sparing, ILM peeling, light sensitivity, contrast sensitivity, low contrast visual acuity