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William R. Freeman, MD; Alay S. Banker, MD; Stanley P. Azen, PhD; Serge de Bustros, MD; Vitrectomy for Macular Hole Study Group
La Jolla, Calif

Arch Ophthalmol. 1997;115(9):1214-1215.

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Dr Holekamp has reported a retrospective review of 170 cases of macular hole surgery and claims that without epiretinal membrane (ERM) peeling there was RPE change present post-operatively in only 2% of the cases. That incidence is more than an order of magnitude lower than what has been reported by the Vitrectomy for Macular Hole Study (VMHS) Group.^1-4 She suggests that ERM peeling and related micromanipulation may be the cause of such RPE change and that such RPE change and potential vision loss could be avoided by not performing ERM dissection. We have shown that eyes that develop RPE changes after macular hole surgery have poorer visual outcomes than eyes that do not.⁵ There is no question that the complication rate of macular hole surgery is high. Despite this, the VMHS Group did demonstrate a visual benefit of macular hole surgery. We believe that this benefit . . . [Full Text PDF of this Article]

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