The Efficacy of Diamond Dusted Membrane Scraper (DDMS) in Macular Hole Surgery

Lee, Jung Hoon; Oum, Boo Sup

Abstract

PURPOSE: The Diamond dusted membrane scraper (DDMS) is a useful instrument for removing the fine cortical vitreous and epiretinal membranes. We report the efficacy of a DDMS in macular hole surgery.
METHODS
We retrospectively reviewed the hospital records of those who were diagnosed as macular hole for the recent 3 years. Twenty five consecutive eyes of twenty three patients underwent pars plana vitrectomy with gas tamponade. Removal of epiretinal membranes and cortical vitreous was performed using either conventional tools or a DDMS. The effects of the DDMS on the anatomical and functional success rate were compared between two groups.
RESULTS
Of 25 eyes, 18 eyes (72.0%) were successfully closed, and 14 eyes (56.0%) had improvement in visual acuity of at least two lines or more. In DDMS group (n=10), all 10 eyes (100%) were successfully closed, compared with 8 eyes (53.3%) of conventional group (n=15) (P=0.013). But we couldn't achieve a significantly higher rate in functional success ; 70.0% vs 46.7% in each group (P=0.173). According to the duration of symptom , we devided all patients into those of 6 months or less and those of more than 6 months. The former (n=16) had a significantly higher rate than the latter (n=9) in anatomical success ; 14 eyes (87.5%) vs 4 eyes (44.4%) (P=0.031). However, there was no significant difference in functional success rate ; 62.5% vs 44.4% in each group (P=0.226).
CONCLUSIONS
The DDMS appears to be more effective than conventional tools for removing epiretinal membranes and cortical vitreous and may increase the anatomical success rate in macular hole surgery.