25G pars plana vitrectomy combined with peeling of the inner limiting membrane and air tamponade in idiopathic macular hole

Objective To evaluate the clinical effect of 25G pars plana vitrectomy with inner limiting membrane peeling and air tamponade for idiopathic macular hole (IMH). Methods Retrospectively examined 28 patients (28 eyes) with IMH in whom 25G vitrectomy, peeling of the inner limiting membrane underwent 0.25mg/ml brilliant blue G(BBG)-assisted, and application of sterile air tamponade were performed. The main observations were the surgical time, best corrected visual acuity (BCVA), intraocular pressure, the healing of macular hole and surgery complications. The follow-up period was 3-24 months (median 12.2±3.6 months). Results The operation lasted for 22-40minutes, meanly 28minutes, 28 cases were all successfully peeled of the inner limiting membrane, macular hole were closed in 28 eyes (100%), visual improvement was achieved in 21 eyes (75%), no eye was worse. The mean BCVA was 0.65±0.194 postoperatively, there was significant statistical differences compared with that before operation (t=13.768, P=0.000). The mean intraocular pressure at postoperative 1 week was (15.3±3.7) mmHg, closed to preoperative level. Eight eyes had punctate retinal hemorrhage when peeling of the inner limiting membrane, 4 eyes had nuclear cataract, 3 eyes had transient higher intraocular pressure, no other serious postoperative complications were observed during the follow-up time in all cases. Conclusions 25G vitrectomy with inner limiting membrane peeling and air tamponade is an effective and safe minimally invasive surgical technique, it can promote healing of macular hole, improve visual acuity, shorten operation time, decrease complication. Key words: 25G vitrectomy; Idiopathic macular hole; Inner limiting membrane peeling