Enlarged ILM Peeling in Idiopatic Macular Hole Surgery A Retrospective Study Claudia Bacalhau


To evaluate the morphological and functional success of vitrectomy with enlarged internal limiting membrane peeling for full-thickness macular hole.


Retrospective study, including 18 patients with full-thickness macular hole that were submitted to vitrectomy with enlarged peeling of internal limiting membrane (until the temporal vascular arcades). The parameters evaluated were the time of evolution of macular hole, its transverse diameter and the visual acuity. Post-surgery results were considered at month 6 of follow up.


18 patients were operated by this technique, 56% female, mean age 69.6 years. The mean time of evolution of macular hole was 5.2 months (min. 1 and max. 24). The transverse diameter of macular holes were between 82 and 719 µm and the mean visual acuity was 0.1 (decimal scale). There was macular hole surgical closure in 15 cases (83.3%), with mean visual acuity improvement from 0.12 to 0.34. In the 3 cases with persistent macular hole its transverse diameter decreased and the visual acuity improved in 2 cases.


Our morphological and functional success rate is similar to other publications, despite the enlarged internal limiting membrane peeling. In persistent macular hole cases, we observed reduction of macular hole diameter and visual acuity improvement, which may suggest a potential beneficial effect of the enlarged peeling technique. Randomized studies with more data will be necessary for better evaluating this technique.