VITREOUS SURGERY FOR IMPENDING MACULAR HOLE

Purpose: In a study conducted 15 years ago, the “Vitrectomy for Prevention of Macular Hole Study Group” was not able to prove the benefits and advantages of vitrectomy for treatment of impending macular holes; however, during the interim period, notable improvements have been achieved concerning diagnosis and efficacy of treatment. This study aims to identify the effect of current vitreous surgery for treatment of symptomatic impending macular holes. Methods: Nineteen eyes of 17 consecutive patients who had undergone vitrectomy with internal limiting membrane peeling and short-acting gas tamponade for treatment of symptomatic impending macular holes were reviewed. Outer foveal defects on preoperative optical coherence tomography were demonstrated in all cases. We analyzed visual outcome and postoperative change in foveal appearance on optical coherence tomography. Results: The follow-up period ranged from 3 months to 41 months, with a mean of 13.5 months. Mean logarithm of the minimum angle of resolution best-corrected visual acuity improved postoperatively from 0.42 ± 0.18 to 0.11 ± 0.11 (P < 0.01). Postoperative optical coherence tomography examination revealed anatomical closure with complete disappearance of outer foveal defects in all patients. Conclusion: In symptomatic patients with impending macular holes, current vitreous surgery may prevent progression to a full-thickness macular hole and improve visual outcome. A randomized trial is warranted.