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The role of muller cell complex in the formation of eccentric macular holes after vitrectomy with internal limiting membrane peeling for the treatment of epiretinal membrane

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 18/09/2015 | 14:30-16:00

Paper Time: 15:02

Venue: Athena

First Author: : Z.Kapran TURKEY

Co Author(s): :    F. Helvacioglu   O. Cam   M. Uyar   Z. Tunc   Z. Akingol   S. Sencan

Abstract Details

PURPOSE:To evaluate the anatomical and clinical features of four patients who developed an eccentric macular hole after surgery for idiopathic epimacular proliferation.


Maltepe University Department of Ophthalmology, Istanbul, Turkey


Four patients are described with eccentric retinal holes. Two holes were observed in one of the patients. Of the five eccentric macular holes, three were located temporal to the fovea, one was located superior to the fovea, and one was located nasal to the fovea, which developed after pars plana vitrectomy and uncomplicated ILM removal for idiopathic epimacular proliferation (n = 4), with the use of trypan blue.


Eccentric macular holes developed 2 months to 12 months (mean, 4.7 months) after epimacular proliferation peeling. The mean horizontal and vertical diameters of the holes were 527 ± 535 μm and 501 ± 471 μm. The mean distance to foveal centre was 3124 ± 1006 μm. The ILM was peeled in addition to the epimacular proliferation in all of the cases. Final visual acuities after a mean follow-up period of 37.2 months were 0.61 Snellen lines.


Eccentric macular hole formation is an infrequent complication of pars plana vitrectomy with internal limiting membrane peeling for epiretinal membrane. Holes were seen on the unpeeled areas of the macula. We believe, that Muller cell complex plays an important role in carrying the traction forces throughout the retina and according to our theory a defect on the intact ILM is essential for hole formation. These holes are asymptomatic, have not required any treatment and have not caused any complications in up to 6.5 years of follow-up.

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