EFFECT OF DEBRIDEMENT OF THE RETINAL-PIGMENT EPITHELIUM IN FULL-THICKNESS MACULAR HOLE SURGERY

We assessed the efficacy of debridement of the retinal pigment epithel ium (RPE) from the base of the macular hole during vitrectomy to treat 83 eyes of 75 patients with a stage 2 (n=29), stage 3 (n=35) or stage 4 (n=19) macular hole. Patients ranged in age from 51 to 77 years (me an, 67.6 pars). Duration of symptoms preoperatively ranged from 1 to 1 20 months (average, 19.2 months). During vitrectomy for macular hole, the RPE at the base of the hole was gently aspirated with either a sil icone-tipped extrusion needle or a blunt-tipped 27-gauge needle. Follo w-up averaged 13.0 months (range, 3 to 36 months). The holes resolved in 73 (88%) of the 83 eyes after one surgical procedure. In 73 eyes wi th a follow-up period of 6 months or more, sixty-five (89%) showed imp roved VA of at least two lines of Snellen equivalent. Fifty-five (75%) eyes had a visual acuity (VA) of greater than or equal to 20/40. Our preliminary results suggest that RPE debridement from the base of the hole is a useful adjunct to vitrectomy for treating full-thickness mac ular holes.