Extent of ILM Removal and Its Impact on Outcomes of MH Surgery
Extent of ILM Removal and Its Impact on Outcomes of MH Surgery
Eligible patients who were scheduled for surgery for idiopathic macular hole (MH) were
 equally randomized to small extent group or large extent group depending on the extent of
 internal limiting membrane (ILM) to be removed. The ILM was peeled in round shape with the
 radius of either 0.75-disc diameter or 1.5-disc diameter according to the group. The primary
 analysis was conducted to identify the difference of functional and anatomical outcomes
 between the two groups. Subsequent analysis was performed to reveal the relationship between
 the functional and anatomical outcomes.
This randomized clinical trial was performed at a single center. Patients who were scheduled
 for surgery for idiopathic macular hole (MH) were enrolled. Eligible patients were equally
 randomized to small extent group or large extent group depending on the extent of ILM to be
 removed. Random numbers were generated through computerized block-randomization.

 A standard 3-port pars plana vitrectomy was performed by a single surgeon using 23-gauge
 vitrectomy system, with a 1-step scleral tunnel incision. After posterior vitreous detachment
 was achieved, peeling of the ILM was performed by an end gripping forceps with the assistance
 of indocyanine green dye. The ILM was peeled in round shape with the radius of either
 0.75-disc diameter or 1.5-disc diameter centering at the center of the MH according to the
 pre-assigned group. This was followed by a complete fluid-gas exchange, and all patients were
 encouraged to maintain a face-down position for at least 5 days postoperatively.

 Postoperative measurements of BCVA and M-score were conducted at 2- and 6-month follow-up
 visits by independent masked observers. The first postoperative SD-OCT scanning was usually
 conducted at 1 to 2 weeks after operation according to the intraocular gas status. Then, OCT
 scans were conducted at follow-up visits 2, and 6 months postoperatively. The same
 experienced examiner conducted all the OCT scans on all subjects.

 Comparison of anatomical closure, BCVA, M-score, Δ BCVA, and Δ M-score were primarily
 performed between the two groups. Then, the parameters measured from OCT scans with changes
 in ETDRS visual acuity and M-score were analyzed.
Inclusion Criteria:

 -  idiopathic macular hole

 Exclusion Criteria:

 -  macular hole associated with other causative diseases