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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Vale, Luke McDonald, Alison Cook, Jonathan Ternent, Laura Boachie, Charles McPherson, Gladys Lois, Noemi Burr, Jennifer Norrie, John |
| Description | Country affiliation: United kingdom Author Affiliation: Lois N ( Ophthalmology Department, Grampian University Hospitals-NHS (National Health Service) Trust, Aberdeen, United Kingdom. noemilois@aol.com) |
| 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 from 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. CONCLUSIONS: 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.). |
| ISSN | 01460404 |
| e-ISSN | 15525783 |
| Journal | Investigative Opthalmology & Visual Science |
| Issue Number | 3 |
| Volume Number | 52 |
| Language | English |
| Publisher | Association for Research in Vision and Ophthalmology |
| Publisher Date | 2011-03-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Epiretinal Membrane Surgery Retinal Perforations Vitreoretinal Surgery Contrast Sensitivity Physiology Cost Of Illness Cost-benefit Analysis Physiopathology Fluorescein Angiography Fluorocarbons Administration & Dosage Health Resources Utilization Phacoemulsification Quality-adjusted Life Years Tomography, Optical Coherence Visual Acuity Vitrectomy Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-u.s. Gov't Discipline Ophthalmology |
| Content Type | Text |
| Resource Type | Article |
| Subject | Ophthalmology Sensory Systems Cellular and Molecular Neuroscience |
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