Success of Pars Plana Vitrectomy (PPV) With Internal Limiting Membrane (ILM) Peel for Management of Macular Hole

Abstract

BACKGROUND: Peeling the internal limiting membrane of the retina has become a very common procedure performed by vitreo retinal surgeons. The combination of new microsurgical instrumentation with the availability of different dyes to stain this thin and transparent membrane has facilitated the performance of internal limiting membrane peeling, reducing the time and trauma associated with this maneuver. It appears that peeling the internal limiting membrane in these retinal conditions may be associated with better anatomical and visual outcomes following surgery.

OBJECTIVE: To determine the frequency of success of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peel for management of macular hole.

METHODS: This was a descriptive case series. Study was conducted at Eye unit III, Institute of Ophthalmology, KEMU/ Mayo Hospital, Lahore. Total 115 patients were included in this study.  Patients selection was done by using pre defined inclusion and exclusion criteria. Data entry and analysis was done by using SPSS 17.

RESULTS: Mean age of all patients was 61.71±5.81 years. Whereas mean age of male and female patients was 61.90±6.10 and 61.49±5.5 years respectively. Macular hole stage of patients showed that 72(63%) patients had stage-II and 43(37%) patients had stage-III. Postoperative serial OCT's was done to measure the size of macular hole at first post operative day, 1^st week, 1^st month and finally on 2^nd post-operative month. Mean OCT pre operatively was 362.93±85.77 (µm), at 1^st day 169.61±57.74 (µm), at 1^st week post operatively 120.17±49.53 (µm), at 1^st month 74.22±61.97 (µm) and at 2^nd month post operatively mean OCT was 30.00±6.53 (µm). Success of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peelwas achieved in 96 (83%) patients while there were 19(17%) patients among them failure was observed.

CONCLUSION: Pars plana vitrectomy with internal limiting membrane  peel for management of macular hole is effective method of treatment. It provides good results for anatomical and functional outcome.