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

Lee, Jung Hoon; Oum, Boo Sup

Original Article

Journal of the Korean Ophthalmological Society 2002;43(3):471-477.
Published online March 1, 2002.

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

Jung Hoon Lee, Boo Sup Oum

Department of Ophthalmology, College of Medicine, Pusan National University Hospital, Korea. bsoum@hyowon.pusan.ac.kr

Diamond dusted membrane scraper (DDMS) 사용에 따른 황반원공 수술성적

이정훈 ( Jung Hoon Lee ) , 엄부섭 ( Boo Sup Oum )

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.

Key Words: Diamond-dusted membrane scraper (DDMS);Macular hole;Vitrectomy