Abstract
In the article by Berinstein et al1Berinstein D.M. Hassan T.S. Williams G.A. et al.Surgical repair of full-thickness idiopathic macular holes associated with significant macular drusen.Ophthalmology. 2000; 107: 2233-2239Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar the authors studied the surgical repair of full-thickness idiopathic macular holes associated with significant macular drusen. The authors reported that a trend of reduced initial macular hole closure was seen in eyes with significant macular drusen, although reoperations improved closure rates. We think the possible reasons for reduced initial macular hole closure rate need further discussion.It was reported that the prevalence of posterior vitreous detachment in eyes with age-related macular degeneration (AMD) is significantly lower than the eyes of age-matched controls without AMD.2Ondes F. Yilmaz G. Acar M.A. et al.Role of the vitreous in age-related macular degeneration.Jpn J Ophthalmol. 2000; 44: 91-93Crossref PubMed Scopus (75) Google Scholar Although the rate of surgical success of removal of posterior hyaloid and/or of any difficulties in stripping of posterior hyaloid intraoperatively are not mentioned in the article, we believe the firm attachment of posterior hyaloid to the retina in the patients with AMD may be one of the possible reasons for the low rate of initial macular hole closure. In addition, the data about the vitreoretinal interface of the cases that showed failure in closing of macular hole in the first operation would be helpful in the explanation of macular hole closure failure. In the article by Berinstein et al1Berinstein D.M. Hassan T.S. Williams G.A. et al.Surgical repair of full-thickness idiopathic macular holes associated with significant macular drusen.Ophthalmology. 2000; 107: 2233-2239Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar the authors studied the surgical repair of full-thickness idiopathic macular holes associated with significant macular drusen. The authors reported that a trend of reduced initial macular hole closure was seen in eyes with significant macular drusen, although reoperations improved closure rates. We think the possible reasons for reduced initial macular hole closure rate need further discussion. It was reported that the prevalence of posterior vitreous detachment in eyes with age-related macular degeneration (AMD) is significantly lower than the eyes of age-matched controls without AMD.2Ondes F. Yilmaz G. Acar M.A. et al.Role of the vitreous in age-related macular degeneration.Jpn J Ophthalmol. 2000; 44: 91-93Crossref PubMed Scopus (75) Google Scholar Although the rate of surgical success of removal of posterior hyaloid and/or of any difficulties in stripping of posterior hyaloid intraoperatively are not mentioned in the article, we believe the firm attachment of posterior hyaloid to the retina in the patients with AMD may be one of the possible reasons for the low rate of initial macular hole closure. In addition, the data about the vitreoretinal interface of the cases that showed failure in closing of macular hole in the first operation would be helpful in the explanation of macular hole closure failure. Surgery for full-thickness macular Holes: author replyOphthalmologyVol. 108Issue 12Preview Full-Text PDF
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