Anatomical and Visual Outcomes of Pars Plana Vitrectomy with Versus Without Internal Limiting Membrane Peeling in Rhegmatogenous Retinal Detachment Associated With Macular Hole

Doi: 10.36351/pjo.v41i3.2062

Abstract

Purpose:  To evaluate the anatomical and visual outcomes of Parsplana vitrectomy (PPV) with and without internal limiting membrane (ILM) peeling in rhegmatogenous retinal detachment (RRD) associated with macular hole (MH).

Study Design:  Interventional case series.

Place and Duration of Study:  Lahore General Hospital from 1^st September 2023 to August 2024.

Methods:  Eighteen patients with rhegmatogenous retinal detachment (RRD) associated with macular hole (MH) were enrolled in the study. All patients underwent a comprehensive ocular examination, including macular optical coherence tomography (OCT). Twelve patients had a macular hole size of less than 400 µm, while six had a size greater than 400 µm. Group I included nine patients who underwent pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, whereas Group II consisted of nine patients who underwent PPV without ILM peeling.Normality assumption was checked using Shapiro-wilk test and  independent t-test test was done for comparison of visual acuity between the two groups.

Results:  Out of 18 patients, 10 were males (55.6%). Mean age was 55±7.1 years (range 44-60 years). In Group-I, 90% had closure of MH regardless of size while in Group-II, 40% had MH closure. Change in visual acuity was -1.0733 ± 0.26476 in Group 1 and -0.9244 ± 0.44427 in Group II (0.401).

Conclusion:  Peeling of ILMas an adjunct to the PPV for surgical repair of macular hole associated with Rhegmatogenous-retinal-detachment has shown promising results in anatomical outcomes (90% closure rate compared to 40%) without a significant impact on visual acuity.

Keywords:  Rhegmatogenous retinal detachment, Macular Hole, Pars Plana Vitrectomy, Internal Limiting Membrane.