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Kumagai K, Horie E, Fukami M, Furukawa M. Macular Hole Surgery as a Historical Perspective. Clin Ophthalmol 2024; 18:1981-1989. [PMID: 39005587 PMCID: PMC11246662 DOI: 10.2147/opth.s466140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose To evaluate the outcomes of macular hole (MH) surgery as a historical perspective after its inception in 1991. Patients and Methods Retrospective review of 1032 eyes of 949 patients with an idiopathic MH who were followed for at least one year after the initial surgery. All surgeries were performed from 1990 to 2016 by one surgeon (NO) and included phacovitrectomy for patients of ≥40-years-of-age, a removal of the posterior hyaloid and epiretinal membrane, and SF6 gas tamponade with a 1-week face-down. After 1998, internal limiting membrane (ILM) peeling became the conventional procedure. All surgeries were classified into four periods based on the year of the initial surgery. The first period was 1990~1995 (n = 222), the second period was 1996~1999 (n=327), the third period was 2000~2004 (n = 234), and the last period was 2005~2016 (n=249). Results The mean follow-up period was 81.3, 79.8, 88.4, and 77.3 months; hole size was 0.33, 0.28, 0.25, and 0.24 disk diameter; hole duration was 15.1, 10.6, 8.2, and 6.1 months; the decimal visual acuity (VA) was 0.13, 0.15, 0.17, and 0.19. The initial closure rate was 61.3, 78.0, 96.6, and 96.4%. The final decimal visual acuity was 0.33, 0.50, 0.66, and 0.79. The rate of a final decimal VA of 0.5 or better was 48.2, 66.4, 82.1, and 88.8%. The rate of a final decimal visual acuity of 1.0 or more was 17.6, 29.3, 43.6, and 58.2%. Multiple regression analyses showed that hole duration and ILM peeling were significantly associated with both the anatomic and functional outcomes. Conclusion The favorable outcomes of MH surgery was primarily achieved by earlier surgery and conventional ILM peeling. Favorable results might be obtained using only conventional ILM peeling.
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Affiliation(s)
- Kazuyuki Kumagai
- Kamiiida Daiichi General Hospital, Nagoya, Aichi, 462-0802, Japan
| | - Eiji Horie
- Yata Eye Clinic, 165-1 Takyo, Izunokuni, Shizuoka, 410-2315, Japan
| | - Marie Fukami
- Kamiiida Daiichi General Hospital, Nagoya, Aichi, 462-0802, Japan
| | - Mariko Furukawa
- Kamiiida Daiichi General Hospital, Nagoya, Aichi, 462-0802, Japan
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Su T, He S, Mao P, Gu C, Meng C, Zhou C, Chen J, Zheng Z, Qiu Q. A three-step approach to close refractory persistent macular holes: a releasing-closing-tapping approach. Graefes Arch Clin Exp Ophthalmol 2023; 261:3415-3423. [PMID: 37561145 PMCID: PMC10667424 DOI: 10.1007/s00417-023-06197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE The aim of this study was to assess the efficacy and safety of a novel releasing-closing-tapping approach in the treatment of persistent macular holes (PMHs) after initial surgery with internal limiting membrane (ILM) peeling. METHODS We retrospectively analyzed patients with PMHs after initial surgery with ILM peeling who were treated with a novel releasing-closing-tapping approach. After repeated pars plana vitrectomy (PPV), the surgeon effectively released the adhesion between the edges and retinal pigment epithelium (RPE) by gently scraping the retinal neuroepithelium. Then, the hole was converted into a transverse slit, and the edges were gently tapped flat so that they attached to the RPE, and no space was left under the edges. Finally, air tamponade was carried out. The primary outcome measures included MH closure and the change in best-corrected visual acuity (BCVA) from preoperatively to postoperatively. RESULTS The study included 11 PMH patients with a mean age of 63.82 ± 3.31 years. The mean minimum linear diameter of PMHs was 666.3 ± 208.1 μm, and the mean basal diameter was 1547.2 ± 351.8 μm. MH closure was achieved in 90.9% (10/11) of eyes, with significant improvement of visual acuity from 1.19 ± 0.30 logMAR to 0.65 ± 0.29 logMAR postoperatively. CONCLUSION The releasing-closing-tapping approach with repeated PPV is a simple, effective, and safe surgical procedure for refractory PMHs after initial surgery with ILM peeling that can significantly improve the visual outcome and achieve a high surgical success rate.
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Affiliation(s)
- Tong Su
- Shandong Eye Hospital, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University, Jinan, China
| | - Shuai He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Peiyao Mao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chunren Meng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Jili Chen
- Shibei Hospital, Jing'an District, Shanghai, People's Republic of China.
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China.
| | - Qinghua Qiu
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, People's Republic of China.
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Chakraborty D, Mondal S. Commentary: To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes. Indian J Ophthalmol 2022; 70:3037-3039. [PMID: 35918968 PMCID: PMC9672763 DOI: 10.4103/ijo.ijo_869_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo-Retina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Soumen Mondal
- Department of Vitreo-Retina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
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Erratum: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2022; 70:2212. [PMID: 35648033 PMCID: PMC9359293 DOI: 10.4103/0301-4738.346035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Romano MR, Rossi T, Borgia A, Catania F, Sorrentino T, Ferrara M. Management of refractory and recurrent macular holes: A comprehensive review. Surv Ophthalmol 2022; 67:908-931. [DOI: 10.1016/j.survophthal.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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Dhawan A, Sreenivasan J. Comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2911. [PMID: 34571691 PMCID: PMC8597483 DOI: 10.4103/ijo.ijo_794_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Atul Dhawan
- Dr Agarwal's Retina Foundation (Vitreo-Retina Services), No. 222, TTK Road, Alwarpet, Chennai, Tamil Nadu, India
| | - Janani Sreenivasan
- Dr Agarwal's Retina Foundation (Vitreo-Retina Services), No. 222, TTK Road, Alwarpet, Chennai, Tamil Nadu, India
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Dudani AI, Dudani AA, Dudani KA, Dudani A. Comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2909-2910. [PMID: 34571688 PMCID: PMC8597458 DOI: 10.4103/ijo.ijo_827_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Anupam A Dudani
- P D Hinduja Hospital and Research Center, Mumbai, Maharashtra, India
| | - Krish A Dudani
- K J Somaiya Medical College and Hospital, Mumbai, Maharashtra, India
| | - Anadya Dudani
- K J Somaiya Medical College and Hospital, Mumbai, Maharashtra, India
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Chakraborty D, Sengupta S, Mukherjee A, Majumdar S. Response to comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2910-2911. [PMID: 34571690 PMCID: PMC8597517 DOI: 10.4103/ijo.ijo_1559_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Angshuman Mukherjee
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
| | - Saptorshi Majumdar
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
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Chakraborty D, Sengupta S, Mukherjee A, Majumdar S. Response to comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2912. [PMID: 34571693 PMCID: PMC8597486 DOI: 10.4103/ijo.ijo_1558_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Angshuman Mukherjee
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Saptorshi Majumdar
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
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