Full Thickness Macular Hole and Internal Limiting Membrane Peeling Study
- Conditions
- Stage 2 or 3 Full Thickness Macular Hole
- Interventions
- Procedure: Vitrectomy, post hyaloid detachment and gas injection with or without ILM peel.
- Registration Number
- NCT00286507
- Lead Sponsor
- University of Aberdeen
- Brief Summary
A macular hole is a fairly common problem in the retina and is an important cause of loss of central vision. The aim of this study is to determine whether, in patients with a stage 2 or 3 full thickness macular hole (FTMH), peeling a very fine, transparent tissue that covers the surface of the retina, called the internal limiting membrane (ILM) during surgery is superior to non-ILM peeling macular hole surgery. The main outcomes are improvement in vision, achievement of macular hole closure, need for re-operation, health related quality of life (HRQOL) and cost effectiveness.
- Detailed Description
Idiopathic full-thickness macular hole (FTMH) is an important cause of loss of central vision, usually leading to severe visual impairment. Up to 20% of affected people will develop a FTMH in both eyes. There is uncertainty in the literature and among vitreo-retinal surgeons about the balance of potential benefits and adverse effects of ILM peeling in FTMH surgery for stage 2-3 holes.
FILMS is a randomised controlled trial (RCT) in patients with stage 2-3 FTMH less less than 18 months duration investigating whether ILM peeling improves the anatomical and visual outcome of macular hole surgery and the quality of life of patients with this retinal disease. Cost-effectiveness is also being addressed.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 141
Idiopathic FTMH of stage 2-3, Duration of hole ≤18 months, Visual acuity equal to or worse than 20/40 in the study eye.
Stage 1 or 4 FTMH, Stage 2-3 FTMH of > 18 months duration, Visual acuity >20/40 in study eye, FTMH related to high myopia (>6 dioptres), FTMH related to trauma, any other causes of decreased vision (ie corneal scarring, age-related macular degeneration, diabetic retinopathy, glaucoma if central and/or paracentral absolute visual field defects present), patient unable to understand English, patient unable to give informed consent.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description ILM peeling Vitrectomy, post hyaloid detachment and gas injection with or without ILM peel. Combined cataract surgery (phacoemulsification and intraocular lens implantation) and pars plana vitrectomy with postoperative intraocular tamponade with gas, with ILM peeling No ILM peeling Vitrectomy, post hyaloid detachment and gas injection with or without ILM peel. combined cataract surgery (phacoemulsification and intraocular lens implantation) and pars plana vitrectomy with postoperative intraocular tamponade with gas without ILM peeling
- Primary Outcome Measures
Name Time Method The primary outcome of the study is the mean difference between treatment groups in the Early Treatment Diabetic Retinopathy Study (ETDRS) distance visual acuity score. 6 months post surgery
- Secondary Outcome Measures
Name Time Method Secondary outcomes include anatomical closure, adverse events, re-operation, distance visual acuity (VA), near VA, contrast sensitivity, reading speed, costs to the health service and the participant and HRQOL. 3, 6 and 24 months post surgery
Trial Locations
- Locations (9)
Aberdeen Royal Infirmary
🇬🇧Aberdeen, United Kingdom
Royal Victoria Eye and Ear Hospital
🇮🇪Dublin, Ireland
Waterford Regional Hospital
🇮🇪Waterford, Ireland
Bristol Eye Hospital
🇬🇧Bristol, United Kingdom
Gartnavel General Hospital
🇬🇧Glasgow, United Kingdom
Ninewells Hospital
🇬🇧Dundee, United Kingdom
Oxford Eye Hospital
🇬🇧Oxford, United Kingdom
Sunderland Eye Infirmary
🇬🇧Sunderland, United Kingdom
Royal Liverpool Hospital
🇬🇧Liverpool, United Kingdom