Limited Vitrectomy in Patients with Idiopathic Macular Hole

BACKGROUND: Partial posterior hyaloidectomy is suggested to minimize traction on the vitreous base and thus reduce the risk of iatrogenic breaks in patients with macular hole and epiretinal membrane. AIMS: To evaluate the safety and efficacy of limited vitrectomy in patients with macular hole. STUDY DESIGN: Retrospective cohort study. METHODS: Fifty-two consecutive patients who underwent macular hole surgery without complete peripheral vitreous removal were included in the study. The improvement in visual acuity, the incidence of retinal breaks and detachment, anatomical results, and intraoperative and postoperative complications of this technique were evaluated. RESULTS: The median visual acuity was 0.2 (0.1-0.4) before surgery and 0.5 (0.3-0.6) after surgery (p<0.001). None of the patients had retinal breaks or detachments. A sulfur hexafluoride was used in 24 patients (46.2%), and perfluoropropane was used in 28 patients (53.8%). Three patients (5.76%) had revision surgery because of recurrence of the macular hole. We did not observe proliferative vitreoretinopathy or surgery-related major complications in any patient during the follow-up period. CONCLUSION: Limited vitrectomy without removal of the peripheral vitreous seems to be effective and safe with minimal risk of peripheral retinal breaks and detachment.