Papillomacular bundle sparing versus conventional internal limiting membrane peeling for idiopathic macular hole ≤ 400 μm

Purpose: To compare the outcomes of papillomacular bundle (PMB) sparing internal limiting membrane (ILM) peeling (group LP) and conventional ILM peeling (group CP) for treatment of idiopathic macular hole (MH) of <= 400 mu m. Methods: Fifteen eyes were included in each group. In group CP, conventional 360 degrees peeling was done, while in group LP, ILM was spared over PMB. The changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness were analyzed at 3 months. Results: MH was closed in all with comparable visual improvement. Postoperatively, retinal nerve fiber layer (RNFL) was significantly thinner in the temporal quadrant in group CP. GC-IPL was significantly thinner in the temporal quadrants in group LP, whereas it was comparable in group CP. Conclusion: PMB sparing ILM peeling is comparable to conventional ILM peeling in terms of closure rate and visual gain, with the advantage of less retinal damage at 3 months.

Automated summary

The study compared the outcomes of papillomacular bundle (PMB) sparing internal limiting membrane (ILM) peeling (group LP) and conventional ILM peeling (group CP) for idiopathic macular hole (MH) treatment of <= 400 mu m. The results showed that both groups achieved successful closure of the macular hole with comparable visual improvement. Postoperatively, the retinal nerve fiber layer (RNFL) was significantly thinner in the temporal quadrant in the CP group. The ganglion cell-inner plexiform layer (GC-IPL) was significantly thinner in the temporal quadrants in the LP group, while it was comparable in the CP group. The study concluded that PMB sparing ILM peeling is comparable to conventional ILM peeling in terms of closure rate and visual gain, with the advantage of less retinal damage at 3 months.