Observation of early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane peeling

Objective: To observe the early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane (ILM) peeling.

Methods: Retrospectively, 25 eyes of idiopathic macular hole in 25 patients were performed vitrectomy surgery with ILM peeling from January of 2001 to October of 2003. All patients maintained the prone position at least 2 weeks after surgery. Slit-lamp examination and optical coherence topography (OCT) were performed to observe the closure of macular hole during 1 month post-operatively.

Results: All but 2 eyes of the ILM around the macular hole were peeled successfully. Slit lamp examination showed the configurations of macular hole disappeared in 23 eyes in 24-48 hours post-operatively and OCT confirmed the macular holes were closed in these eyes during 1 month after surgery. The anatomical closure rate was 92%. The repaired macular holes were classified by the OCT images as being of "simple closure" or "bridge shape".

Conclusions: The majority of the idiopathic macular holes were closed in the early stage after surgery. It suggests that there are no or very little tissue loss in the process of idiopathic macular hole, after dismissing the mechanic traction caused by vitreous especially ILM, the hole could be closed.