Vitrectomy in Small idiopathic MAcuLar hoLe (SMALL) study: Internal limiting membrane peeling versus no peeling
- Authors: Marolo P.; Caselgrandi P.; Fallico M.; Parisi G.; Borrelli E.; Ricardi F.; Gelormini F.; Ceroni L.; Reibaldi M.; Ferrari T.M.; Lorusso M.; Primavera V.; Giuliani G.; Mariotti C.; Lupidi M.; Ventre L.; Pintore G.; Motta L.; Ripa M.; Boscia F.; Boscia G.; Romano M.R.; Ferrara M.; Miroslav K.; Marchina D.; Parolini B.; Peiretti E.; Marchiori V.; Dell'Omo R.; Affatato M.; Avitabile T.; Russo A.; Longo A.; Scorcia V.; Carnevali A.; Mastropasqua R.; Toto L.; Vaiano A.S.; Merli R.; Mura M.; Pellegrini M.; Giansanti F.; Nicolosi C.; Badino M.; Lavorante N.P.; Sandinha M.T.; D'Alterio F.M.; Toro M.D.; Rejdak R.; Chelazzi P.; Azzolini C.; Viola F.; Dona C.; Cereda M.G.; Casaluci M.; Codenotti M.; Iuliano L.; Pertile G.; Sindaco D.; De Cilla S.; Muraca A.; Bonfiglio V.M.E.; Vadala' M.; La Mantia A.; Randazzo V.; Fiore T.; Tosi G.; Frisina R.; Angeli C.; Coassin M.; Laborante M.; Rossi T.; Cosimi P.; Rizzo S.; Carla M.M.; Gharbiya M.; Albanese G.M.; Caretti L.; Angelini E.; Tosi G.M.; Bacci T.; Steel D.H.; Dervenis N.; Vagiakis I.; Tognetto D.; Pastore M.R.; Faraldi F.; Lavia C.A.; Lanzetta P.; Veritti D.; Rubinato L.; Radice P.; Govetto A.
- Publication year: 2025
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/670645
Abstract
Purpose: To compare vitrectomy with and without internal limiting membrane (ILM) peeling in small idiopathic macular holes. Methods: Retrospective multicentre study including consecutive eyes with ≤250 μm idiopathic macular hole treated with vitrectomy. The primary outcome was hole closure rate. Best-corrected visual acuity (BCVA) change, closure patterns on optical coherence tomography, rates of external limiting membrane (ELM) and ellipsoid zone (EZ) recovery, and rate of complications were also investigated. Results: In total, 693 eyes were included. Hole closure rate was 98% in the peeling and 85% in the no-peeling group (p < 0.001). At 12 months, mean BCVA change was 0.38 ± 0.22 logMAR in the peeling and 0.45 ± 0.21 logMAR in the no-peeling group (p = 0.02); 66% versus 80% of eyes had a U-shaped morphology, respectively; EZ recovery rate was 75% and 93%, respectively (p = 0.02). In the no-peeling group, eyes with a vitreomacular traction (VMT) showed a 96% closure rate, comparable to the peeling group (p = 0.40). The incidence of adverse events was similar except for dissociated optic nerve fibre layer (55% in the peeling vs. 9% in the no-peeling group, p < 0.001). Conclusions: In small idiopathic macular holes, ILM peeling provides a higher closure rate compared to no-peeling; however, if a VMT is present closure rates are comparable. In closed macular holes, the no-peeling technique provides advantages in terms of visual outcome and anatomical recovery.