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Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole : a pragmatic randomized controlled trial
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dc.contributor.author | Lois, Noemi | |
dc.contributor.author | Burr, Jennifer Margaret | |
dc.contributor.author | Norrie, John | |
dc.contributor.author | Vale, Luke | |
dc.contributor.author | Cook, Jonathan | |
dc.contributor.author | McDonald, Alison | |
dc.contributor.author | Boachie, Charles | |
dc.contributor.author | Ternent, Laura | |
dc.contributor.author | McPherson, Gladys | |
dc.contributor.author | Full-Thickness Macular Hole | |
dc.date.accessioned | 2012-06-29T16:31:02Z | |
dc.date.available | 2012-06-29T16:31:02Z | |
dc.date.issued | 2011-03 | |
dc.identifier | 16573535 | |
dc.identifier | 3793b5bf-4aa6-4d08-9b31-fa16f0119128 | |
dc.identifier | 000288965300046 | |
dc.identifier | 79955930425 | |
dc.identifier.citation | Lois , N , Burr , J M , Norrie , J , Vale , L , Cook , J , McDonald , A , Boachie , C , Ternent , L , McPherson , G & Full-Thickness Macular Hole 2011 , ' Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole : a pragmatic randomized controlled trial ' , Investigative Ophthalmology & Visual Science , vol. 52 , no. 3 , pp. 1586-1592 . https://doi.org/10.1167/iovs.10-6287 | en |
dc.identifier.issn | 0146-0404 | |
dc.identifier.other | ORCID: /0000-0002-9478-738X/work/60196150 | |
dc.identifier.uri | https://hdl.handle.net/10023/2875 | |
dc.description.abstract | PURPOSE. To determine whether internal limiting membrane (ILM) peeling is effective and cost effective compared with no peeling in patients with idiopathic stage 2 or 3 full-thickness maculay hole (FTMH). METHODS. This was a pragmatic multicenter randomized controlled trial. Eligible participants front nine centers were randomized to ILM peeling or no peeling (1:1 ratio) in addition to phacovitrectomy, including detachment and removal of the posterior hyaloid and gas tamponade. The primary outcome was distance visual acuity (VA) at 6 months after surgery. Secondary outcomes included hole closure, distance VA at other time points, near VA, contrast sensitivity, reading speed, reoperations, complications, resource use, and participant-reported health status, visual function, and costs. RESULTS. Of 141 participants randomized in nine centers, 127 (90%) completed the 6-month follow-up. Nonstatistically significant differences in distance visual acuity at 6 months were found between groups (Mean difference, 4.8; 95% confidence interval [CI], -0.3 to 9.8; P = 0.063). There was a significantly higher rate of hole closure in the ILM-peel group (56 [84%] vs. 31 [48%]) at 1 month (odds ratio [OR], 6.23; 95% CI, 2.64-14.73; P < 0.001) with fewer reoperations (8 [12%] vs. 31 [48%]) performed by 6 months (OR, 0.14; 95% CI, 0.05-0.34; P < 0.001). Peeling the ILM is likely to be cost effective. CONCLUSION. There was no evidence of a difference in distance VA after the ILM peeling and no-ILM peeling techniques. An important benefit in favor of no ILM peeling was ruled out. Given the higher anatomic closure and lower reoperation rates in the ILM-peel group, ILM peeling seems to be the treatment of choice for idiopathic stage 2 to 3 FTMH. (Clinical Trials.gov number, NCT00286507.) (Invest Ophthalmol Vis Sci 201152: 1586-1592) DOI:10.1167/iovs.10-6287 | |
dc.format.extent | 7 | |
dc.format.extent | 212992 | |
dc.language.iso | eng | |
dc.relation.ispartof | Investigative Ophthalmology & Visual Science | en |
dc.subject | Clinical trial | en |
dc.subject | Surgery | en |
dc.subject | Vitrectomy | en |
dc.subject | Removal | en |
dc.subject | Stage-2 | en |
dc.subject | RE Ophthalmology | en |
dc.subject.lcc | RE | en |
dc.title | Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole : a pragmatic randomized controlled trial | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.identifier.doi | 10.1167/iovs.10-6287 | |
dc.description.status | Peer reviewed | en |
dc.identifier.url | http://aura.abdn.ac.uk/handle/2164/2645 | en |
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