Internal limiting membrane removal in the management of full-thickne macular hole

PURPOE: To determine the effectivene of removal of the internal limiting membrane in the treatment of full-thickne macular hole. METHOD: Data were reviewed from a propective tudy on 47 conecutive eye with full-thickne macular hole undergoing vitrectomy, internal limiting membrane maculorhexi, and fluid-ga exchange. No eye underwent repeat macular hole urgery. A meta-analyi wa performed to compare the outcome of different urgical technique in the treatment of full-thickne macular hole. REULT: The outcome meaure were diappearance of the ubmacular fluid and the change in bet-corrected viual acuity. The urgery wa anatomically ucceful in 44 of the 46 eye (96%) and 39 of the eye (85%) howed an improvement of at leat two nellen line. Bet-corrected final viion wa 20/40 in 18 (39%) eye. No permanent complication pecifically caued by the removal of the macular internal limiting membrane were detected; the minor hemorrhage and retinal edema een in mot eye reolved pontaneouly. Retinal detachment developed and wa uccefully treated in three eye (7%). A meta-analyi on 1,654 eye from publihed report howed that internal limiting membrane maculorhexi appear to ignificantly (P < .0001) increae the anatomical and functional ucce rate in macular hole urgery. CONCLUION: Internal limiting membrane removal i an important development in the evolving field of macular hole urgery. A randomized, propective, multicenter clinical trial hould be performed to determine which urgical technique i the mot beneficial in patient with full-thickne macular hole.