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  • LHEP embedding has an edge over ILM peeling alone for lamellar macular holes

    Retina/Vitreous

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    Review of: Embedding technique versus conventional internal limiting membrane peeling for lamellar macular holes with epiretinal proliferation

    Kanai M, Sakimoto S, Takahashi S, et al. Ophthalmology Retina, September 2022

    Examination of patient outcomes of PPV with lamellar hole–associated epiretinal proliferation (LHEP) embedding and conventional internal limiting membrane (ILM) peeling vs. PPV with ILM peeling only revealed better acuity and anatomic outcomes with the LHEP embedding technique for lamellar macular holes (LMHs).

    Study design

    This was a single-center retrospective study of 39 patients (40 eyes) with LMHs and LHEP. The study included 23 eyes that underwent PPV with LHEP embedding technique and ILM peeling (group E) and 17 eyes that underwent PPV with ILM peeling only (group I).

    Outcomes

    The postoperative BCVA was significantly better in Group E at the 3-month follow-up (P = 0.001) and the final visit (P < 0.001), but there was no significant visual improvement at 3 months (P = 0.565) or the final visit (P = 0.649) in group I. Patients in group I had lower visual acuity at the final visit than in the preoperative period. There was no statistical difference in the post-operative vision or vision improvement between the 2 groups. There was significantly lower post-operative macular hole formation in group E (0/23) compared to group I (5/17, p = 0.005).

    Limitations

    The sample size is small, and it is a retrospective study.

    Clinical significance

    The embedding technique appears to have a trend toward better visual outcomes in patients with LHEP and a lower incidence of post-operative full thickness macular holes.