Macular Hole Surgery with Scraping the Retinal Pigment Epithelium: A Pilot Study

ABSTRACT

We performed vitreous surgery for stage 3 or 4 idiopathic macular holes and assessed the efficacy of basal retinal pigment epithelial scraping in postoperative healing of macular holes. Twelve eyes of 12 patients were included. Mean duration of symptom was 12.75 months and mean age was 65.7 years. 9 patients(75%) were female and three eyes(25%) had macular holes larger than 1/3 disc diameter. The preoperative visual acuity was 0.1 or worse in eleven eyes(92%). Postoperatively, hole closed in ten eyes(83%) and the visual acuity improved two line or more in all eyes(100%) with mean follow-up time of 12.8 months. In 5 eyes(42%), the visual acuity improved 0.3 or better. Anatomical success seemed to be related to the preoperative hole size, which statistically had no significant relationship(p=0.0593). Retinal pigment epithelial alteration was notified in three eyes(25%). This result suggests retinal pigment epithelial scraping may become adjunctive therapy in macular hole surgery and, however, care has to be taken to prevent from inducing retinal pigment epithelial alteration.