Masanori Iwasaki, Hiroyuki Nakashizuka, Naoki Nezu, Mai Omori, Koji Tanaka, Ryusaburo Mori, Hiroyuki Shimada
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引用次数: 0
Abstract
Purpose: This study aimed to evaluate the impact of an epiretinal membrane (ERM) on the postoperative outcomes of full-thickness macular hole (MH) repair, focusing on anatomical closure rates, postoperative visual acuity, and recovery of the outer retinal layers.
Design: A retrospective cohort study PARTICIPANTS: 605 eyes from 594 patients who underwent MH surgery from 2015 to 2023.
Methods: Patients were divided into two groups (MH with ERM [254 eyes] and MH without ERM [351 eyes]). Multiple regression analysis was employed to evaluate surgical outcomes, adjusting for minimum hole size and high myopia in relation to the initial MH closure rate and for preoperative visual acuity and concurrent cataract surgery in relation to postoperative visual acuity at 3 months. In all cases, ERM and internal limiting membrane (ILM) peeling were performed, and the inverted ILM flap cover technique was added at the discretion of the surgeon. Patients with MH-associated retinal detachment, myopic foveoschisis and recurrent or traumatic MH were excluded.
Main outcome measures: The initial MH closure rate and postoperative visual acuity at 3 months were evaluated using multiple regression analysis.
Results: Our results indicated that ERM did not significantly impact MH closure rates (97.2% vs. 98.3%, p = 0.554), which was consistent with the findings of the multiple regression analysis (r = -0.310, p = 0.666). The inverted ILM flap technique effectively promoted MH closure even in the presence of an ERM (p = 0.021). The MH with ERM group had significantly worse postoperative visual acuity at 3 months (p = 0.004) and significantly lower restoration rates of the outer nuclear layer (64.4% vs. 75.1%, p = 0.006) and external limiting membrane (82.2% vs. 90.1%, p = 0.007).
Conclusions: An ERM does not significantly affect anatomical MH closure. The inverted ILM flap technique is effective for MH closure even in the presence of an ERM. An ERM negatively impacted postoperative visual acuity and outer retinal layer restoration.
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