A randomised controlled trial evaluating internal limiting membrane peeling forceps in macular hole surgery
Purpose To assess study design and a range of anatomical and functional changes after internal limiting membrane (ILM) peeling using forceps developed for atraumatic ILM pick-up compared to standard forceps. Methods We conducted a masked proof-of concept randomised controlled trial (RCT) on 65 patie...
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Published in | Graefe's archive for clinical and experimental ophthalmology Vol. 261; no. 6; pp. 1553 - 1562 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.06.2023
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
To assess study design and a range of anatomical and functional changes after internal limiting membrane (ILM) peeling using forceps developed for atraumatic ILM pick-up compared to standard forceps.
Methods
We conducted a masked proof-of concept randomised controlled trial (RCT) on 65 patients who underwent ILM peeling for idiopathic full-thickness macular hole (FTMH) using etched-tip forceps (etched-tip group, 33 eyes) compared to standard ILM forceps (smooth-tip group, 32 eyes). Patients were assessed preoperatively, 3 weeks, 3 and 6 months postoperatively.
Results
The primary closure rate was 95.4%. There was no statistically significant difference between the groups in terms of final visual acuity (66.9 vs 70.9 ETDRS letters,
p
= 0.13), difference of visual field mean deviation (1.32 vs 1.14 decibels), and number of eyes with pick-up-related retinal haemorrhages (16% vs 16%,
p
= 0.96), swelling of arcuate nerve fibre layer lesions (63% vs 55%,
p
= 0.54), number of dissociated optic nerve fibre layer lesions (31.4 vs 41.0,
p
= 0.16), nor inner retina defects (37% vs 22%,
p
= 0.17). Similar changes in inner retinal volumes were detected in all 9 sectors of an ETDRS grid except for a trend (
p
= 0.06) towards a lower reduction in the inferior inner sector in the etched-tip group.
Conclusions
The study was successfully completed with masking maintained and a low risk of bias. Multiple endpoints relating to ILM peeling were assessed, and estimates were provided that can be used for future studies. Although the study was not powered to assess any specific endpoint, the anatomical and functional outcomes assessed did not significantly differ. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
ISSN: | 0721-832X 1435-702X |
DOI: | 10.1007/s00417-022-05932-y |