Abstract：
PURPOSE:To compare the ultrastructural features of excised tissue removed during surgery for idiopathic macular holes with the preoperative stage of the macular hole. METHODS:Twelve consecutive patients with a unilateral idiopathic macular hole underwent vitrectomy with surgical removal of the internal limiting membrane of the retina and epiretinal tissue overlying and surrounding the hole. The excised specimens were evaluated with transmission electron microscopy, and findings were compared with the preoperative stage of the macular hole according to the classification of Gass. RESULTS:Surgery was performed on 12 eyes of 12 patients with stage 2, 3, or 4 macular holes. Internal limiting membrane was present in 11 of 12 specimens. Tissue from one of two eyes with stage 2 holes showed cellular elements enmeshed in cortical vitreous. Tissue from four of seven eyes with stage 3 holes and three of three eyes with stage 4 holes had cellular proliferation on the internal limiting membrane. Cells with myofibroblastic differentiation were present in five of the eight cellular proliferations. CONCLUSION:Our results support the clinical stages of idiopathic macular holes described by Gass. Idiopathic macular holes appear to form from contraction of the prefoveal vitreous, and the hole enlarges because of contraction of myofibroblasts on the inner surface of the internal limiting membrane. On the basis of the mechanical mechanisms of idiopathic macular hole formation, removal of the internal limiting membrane and adherent epiretinal tissue surrounding and overlying the macular hole is a reasonable surgical approach to close idiopathic macular holes.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Yooh HS,Brooks HL Jr,Capone A Jr,L'Hernault NL,Grossniklaus HEdoi
10.1016/s0002-9394(14)71965-8subject
Has Abstractpub_date
1996-07-01 00:00:00pages
67-75issue
1eissn
0002-9394issn
1879-1891pii
S0002-9394(14)71965-8journal_volume
122pub_type
杂志文章abstract：PURPOSE:To report the clinical outcome in 48 eyes of 48 children who received a Baerveldt glaucoma implant (BGI) for the management of pediatric glaucoma. DESIGN:Retrospective, noncomparative case series. METHODS:The medical records of all patients with pediatric glaucoma who underwent a BGI at two tertiary care refe...
journal_title：American journal of ophthalmology
pub_type： 杂志文章,多中心研究
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journal_title：American journal of ophthalmology
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journal_title：American journal of ophthalmology
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更新日期：2019-09-01 00:00:00
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pub_type： 临床试验,杂志文章
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更新日期：1975-10-01 00:00:00
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journal_title：American journal of ophthalmology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1992-06-15 00:00:00
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journal_title：American journal of ophthalmology
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更新日期：1986-06-15 00:00:00
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更新日期：2009-12-01 00:00:00
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journal_title：American journal of ophthalmology
pub_type： 杂志文章
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更新日期：2004-06-01 00:00:00
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journal_title：American journal of ophthalmology
pub_type： 杂志文章
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更新日期：2017-11-01 00:00:00
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更新日期：2012-12-01 00:00:00
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journal_title：American journal of ophthalmology
pub_type： 杂志文章
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journal_title：American journal of ophthalmology
pub_type： 杂志文章
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更新日期：1976-01-01 00:00:00
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journal_title：American journal of ophthalmology
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更新日期：2016-10-01 00:00:00
