Retina (Philadelphia, Pa.) · 2026
EPIRETINAL PROLIFERATION EMBEDDING WITHOUT INTERNAL LIMITING MEMBRANE PEELING FOR LAMELLAR MACULAR HOLE.
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Adamo Ginevra G, Pellegrini Marco, Talli Pietro M, Mondin Riccardo, Cartabellotta Antonio, Giannaccare Giuseppe, Mura Marco
Аннотация
PURPOSE: To report anatomical and functional outcomes of epiretinal proliferation (EP) embedding without internal limiting membrane peeling for lamellar macular holes (LMHs) with EP.
METHODS: This retrospective interventional case series involved patients with idiopathic LMHs and EP who underwent pars plana vitrectomy using the EP-embedding technique without internal limiting membrane peeling. The EP was peeled centripetally, left connected to the LMH edge, and embedded into the retinal cleavage plane. 20% sulfur hexafluoride gas tamponade was applied. After surgery, patients were recommended to avoid lying face-up.
RESULTS: Fifteen eyes of 15 patients were included, and the mean follow-up was 12 ± 8 months. Lamellar macular hole closure was achieved in 100% of cases. Best-corrected visual acuity and central retinal thickness showed significant postoperative improvement, from 0.31 ± 0.20 logMAR (20/40 Snellen) and 156.5 ± 40.7 µ m preoperatively to 0.10 ± 0.12 logMAR (20/25 Snellen) ( P = 0.002) and 221.5 ± 46.5 µ m ( P < 0.001), respectively. Ellipsoid zone (EZ) and external limiting membrane restoration rates were 50% and 100%, respectively. No cases of full-thickness macular hole formation, LMH recurrence, or major complications were observed.
CONCLUSION: EP-embedding without internal limiting membrane peeling yields favorable anatomical and functional outcomes in LMHs with EP and supports the nontractional pathophysiology of the condition.
METHODS: This retrospective interventional case series involved patients with idiopathic LMHs and EP who underwent pars plana vitrectomy using the EP-embedding technique without internal limiting membrane peeling. The EP was peeled centripetally, left connected to the LMH edge, and embedded into the retinal cleavage plane. 20% sulfur hexafluoride gas tamponade was applied. After surgery, patients were recommended to avoid lying face-up.
RESULTS: Fifteen eyes of 15 patients were included, and the mean follow-up was 12 ± 8 months. Lamellar macular hole closure was achieved in 100% of cases. Best-corrected visual acuity and central retinal thickness showed significant postoperative improvement, from 0.31 ± 0.20 logMAR (20/40 Snellen) and 156.5 ± 40.7 µ m preoperatively to 0.10 ± 0.12 logMAR (20/25 Snellen) ( P = 0.002) and 221.5 ± 46.5 µ m ( P < 0.001), respectively. Ellipsoid zone (EZ) and external limiting membrane restoration rates were 50% and 100%, respectively. No cases of full-thickness macular hole formation, LMH recurrence, or major complications were observed.
CONCLUSION: EP-embedding without internal limiting membrane peeling yields favorable anatomical and functional outcomes in LMHs with EP and supports the nontractional pathophysiology of the condition.