Surgical outcomes of lamellar macular holes with and without lamellar hole‐associated epiretinal proliferation

Purpose To report the clinical findings and surgical outcomes of lamellar macular holes ( LMH s) with and without lamellar hole‐associated epiretinal proliferation ( LHEP ). Methods A retrospective review was performed of 73 eyes of 73 patients who underwent vitrectomy for LMH . Patients were grouped according to the presence of LHEP on preoperative spectral‐domain optical coherence tomography (SD‐ OCT ). Postoperative best‐corrected visual acuity ( BCVA ) and OCT features were compared between LMH patients with and without LHEP . Results Lamellar hole‐associated epiretinal proliferation (LHEP) was found in 15 of 73 eyes with LMH s (20.5%). The mean age was 65.0 years. The mean follow‐up duration was 21.5 months. Preoperatively, eyes with LHEP were characterized by a greater hole diameter (p = 0.007), thinner fovea (p = 0.002) and greater incidence of outer retinal disruption (p < 0.001). Best‐corrected visual acuity (BCVA) significantly improved after surgery in eyes without LHEP (p < 0.001), but showed no change in eyes with LHEP (p = 0.185). Initial BCVA was not different between the two groups; however, final BCVA was better in eyes without LHEP (logarithm of the minimum angle of resolution (log MAR ) BCVA , 0.10 ± 0.10 versus 0.33 ± 0.40, p = 0.003). OCT evaluations of postoperative foveal configurations showed no difference between the two groups (p = 0.171). No case developed a full‐thickness macular hole after surgery. Conclusion There was no visual benefit after surgery in LMH patients with LHEP . Different surgical indications for LMH s may be warranted based on the presence of LHEP ‐associated pathology.