BURACO MACULAR IDIOPÁTICO: RESULTADOS ANATÓMICOS E FUNCIONAIS A 12 MESES DAS DIFERENTES TÉCNICAS CIRÚRGICAS

Abstract

Introduction: Idiopathic macular hole is a disease from the vitreoretinal interface whose treatment is pars plana vitrectomy. Chosen techniques included additional internal limiting membrane peeling, inverted flap or internal limiting membrane transplant. There is few evidence about the efficacy of these procedures on the regeneration rate of the external retinal layers.

Objective: To compare results between surgical techniques and evaluate the regeneration of the external retinal layers.

Methods: Cohort and retrospective study of patients diagnosed with idiopathic macular hole who underwent pars plana vitrectomy between January 2017 and December 2018 at Hospital of Braga. Variables evaluated were best corrected visual acuity, macular hole’s size, presence of epiretinal membrane, time until surgery and anatomical success. Regeneration rate of external retinal layers – outer nuclear layer, external limiting membrane, ellipsoid zone and interdigitation zone – was analysed.

Results: This study evaluated 59 eyes, 42 (79,2%) were women and the mean age was 67,3±10,9 years. The best anatomical success rate was achieved in inverted flap technique (93,5%). Best-corrected visual acuity gain was higher with internal limiting membrane peeling (p<0.001). The presence of epiretinal membrane, macular hole’s size and time until surgery were not determinant to choose the technique employed, neither for the anatomical success. Progressive gain of the external retinal layers was observed, with no statistical differences between them during the follow-up period.

Conclusion: Pars plana vitrectomy is anatomic and functional efficient for idiopathic macular hole treatment. The inverted flap technique is better for anatomical success but internal limiting membrane peeling resulted in better visual outcome.