SPARING VERSUS REMOVAL OF EPIRETINAL PROLIFERATION IN THE SURGICAL REPAIR OF FULL-THICKNESS MACULAR HOLES

Purpose: To evaluate the efficacy of vitrectomy with epiretinal proliferation (EP) sparing for full-thickness macular hole accompanied by EP. Methods: A multicenter, retrospective study. Eyes were divided into two groups: the sparing group (Group S) included eyes in which the EP around the hole was peeled and preserved, whereas the removal group (Group R) included eyes in which the EP was partially or completely removed. The internal limiting membrane was peeling in all eyes. Results: Forty-six eyes were included. Twenty-five eyes were in Group S, and 21 eyes were in Group R, with no difference in preoperative best-corrected visual acuity (BCVA) (P = 0.96). After primary surgery, macular holes were closed in all eyes, and there were no complications in either group. Postoperative 12-month BCVA significantly improved in both groups (both P, 0.01), while Group S had better 12-month BCVA than Group R (P = 0.016). In the multivariable analysis, EP sparing was associated with better BCVA at 12 months (P = 0.006) after accounting for the minimal macular hole size and preoperative BCVA. Conclusion: Epiretinal proliferation sparing and removal were both safe and effective techniques, while EP sparing may provide a favorable outcome for eyes with full-thickness macular hole and EP.