Controversies over the role of internal limiting membrane peeling during vitrectomy in macular hole surgery

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• 作者：Francesco Morescalchi ; MD^a ; Ciro Costagliola ; MD^b ; ^c ; Elena Gambicorti ; MD^a ; Sarah Duse ; MD^a ; ^{sarah.duse@alice.it} ; Mario Rosario Romano ; MD^d ; Francesco Semeraro ; MD^a
• 关键词：vitreomacular surgery ; internal limiting membrane removal ; vital dye staining ; Mü ; ller cells ; vitreomacular diseases ; vitreomacular traction
• 刊名：Survey of Ophthalmology
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：62
• 期：1
• 页码：58-69
• 全文大小：989 K
• 卷排序：62

文摘

Surgical management of an idiopathic macular hole consists of vitrectomy to release vitreofoveal traction and intraocular tamponade to flatten and reappose the hole's edges. The intentional atraumatic removal of the internal limiting membrane has been proposed as cost-effective option in macular hole surgery. The internal limiting membrane contributes to tangential traction at the edges of the hole and acts as a platform on which glial cells proliferate. Removal of the internal limiting membrane increases the elasticity of the denuded macula and improves the anatomical success rate; however, the visual consequences of this surgical maneuver are still not fully known. We discuss the beneficial and adverse effects associated with internal limiting membrane peeling in macular hole surgery, highlighting the internal limiting membrane's role in macular hole etiology and pathogenesis and the anatomical and functional findings after its removal.