The Peeling Of The Internal Limiting Membrane Following The Failed Surgery Of Idiopathic Macular Holes

Objective: The aim of the present study was to evaluate the clinical results of parsplana vitrectomy (PPV) combined with the surgical enlargement of internal limitingmembrane (ILM) peeling in patients who had previously undergone failed idiopathicmacular hole (IMH) surgery.Method：In the study,134eyes from130IMH patients who had received PPVcombined with ILM peeling surgery (2-4disk diameters) were analyzed. Within thiscohort,14eyes had IMHs that were not closed, of which13eyes underwent a secondsurgery involving enlargement of the ILM peeling. The extent of the ILM peeling wasincreased to the vascular arcades of the posterior fundus in the secondary surgery. Ofthe13eyes that underwent secondary surgery, five were in stage III and eight were instage IV.Result: The second surgery successfully achieved IMH closure in61.5%(8/13) of theeyes，80％(4/5) in stage III and50%(4/8) in stage IV. The IMH was completelyclosed following surgery and the logMAR vision increased from0.98to0.84(P=0.013) in the8successfully treated cases. The five unclosed eyes showed slightlyimproved visions6months following the surgical enlargement of ILM peeling, themean visual acuity of1.026was improved to1,010, this difference was not found tobe significantly differen（tP=0.186）. There were no complications, such as bleeding orretinal tears.Conclusion: The surgical enlargement of ILM peeling closed the IMHs and improvedvision in the majority of patients. In addition, the procedures were safe. Therefore, theresults of the present study indicate that enlargement of ILM peeling may be aneffective therapy for patients who have previously undergone the failed surgicalcorrection of an IMH.