Management of rhegmatogenous retinal detachment with coexistent macular hole in the era of internal limiting membrane peeling

Edwin H. Ryan, Carolyn T Bramante, Robert A. Mittra, Sundeep Dev, Steven R. Bennett, David F. Williams, Herbert L. Cantrill

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Purpose: To review outcomes of vitrectomy plus or minus scleral buckling for retinal detachment (RD) attributable to peripheral break(s) with noncausal macular hole, plus or minus internal limiting membrane (ILM) peeling. Design: Retrospective chart review. Methods: Forty-nine consecutive patients from March 1, 1998 to March 31, 2009 with RD attributable to peripheral break and macular hole were treated by vitrectomy. Five had no scleral buckle placed. Forty-three underwent ILM peeling. Results: The main outcome measures were retinal reattachment, macular hole status, and vision. Final retinal reattachment rate was 95.9% (47/49) with 1 and 100% with 2 operations. Final macular hole closure rate was 39/43 with ILM peeling (90.7%), and 2/6 without (33.3%, P value =.0041). Mean final acuity was 20/120, and 20/100 if the macular hole was closed. Conclusion: Vitrectomy, plus or minus scleral buckle, with ILM peeling is effective for repair of RD with macular hole. ILM peeling can increase the rate of macular hole closure.

Original languageEnglish (US)
Pages (from-to)815-819.e1
JournalAmerican journal of ophthalmology
Issue number5
StatePublished - Nov 2011

Bibliographical note

Funding Information:
The authors indicate no funding support. Ed Ryan is the recipient of consulting fees from Alcon. Sundeep Dev indicates an unpaid speaking engagement for Genentech. David Williams has been a consultant for Genentech, Merck, and Surmodics. Herbert Cantrill received grant support for a Genentech investigator sponsored trial. Involved in conception and design (E.R.); analysis and interpretation (E.R., C.B.); writing the article (E.R., C.B.); critical revision of the article (E.R., C.B.); final approval of the article (E.R., C.B.); data collection (E.R., R.M., S.D., S.B., D.W., H.C.); provision of materials, patients, or resources (E.R.); statistical expertise (C.B.); literature search (E.R., C.B.); and administrative, technical, or logistical support (E.R., C.B.). The research was approved by Allina Institutional Review Board, Minneapolis, Minnesota.

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