Subtotal vitrectomy in idiopathic macular hole surgery.

Purpose: To assess the outcomes of subtotal vitrectomy in idiopathic macular hole (IMH).

Methods: The patients with idiopathic IMH who had undergone vitreoretinal surgery and followed up for at least 12 months post-operatively were included. First the posterior hyaloid was detached, then cortical vitreous was removed incompletely by leaving anterior vitreous intact. Internal limiting membrane was peeled with the aid of brilliant blue. A non-expanding volume of perfluoropropane was used as a tamponade and face-down positioning for 5 days was suggested to the patients. The main outcome measure was the closure rate of IMH.

Results: Forty-three eyes were included. The mean follow-up time was 15.0 ± 3.8 months after surgery. Single surgery anatomical success was 86.0%. The mean BCVA at baseline, month 1, 3, 6, 12 and at the last follow-up was 0.99 ± 0.33 LogMAR (0,5-1.80), 1.04 ± 0.33 LogMAR (0.5-1.8), 0.94 ± 0.46 LogMAR (0.3-3.0), 0.84 ± 0.33 LogMAR (0.3-1.5), 0.82 ± 0.35 (0.2-1.5), and 0.70 ± 0.34 (0.1-1.5) (p > 0.05, for all). The mean visual acuity increased by 2.9 lines at the last follow-up visit and 51.2% of the patients gained ≥ 3 lines of vision.

Conclusion: The results of this study indicated limited core vitrectomy as a safe and effective surgical technique in the treatment of IMH, resulting in acceptable functional and anatomical outcomes without significant intra- and post-operative complications.