Surgical Management of Lamellar Macular Hole

This chapter explores the surgical management of lamellar macular holes (LMH), a partial-thickness macular anomaly characterized by foveal contour irregularities, inner foveal break, and separation of inner foveal retina from the outer retina. The causes, pathogenesis, clinical features, and natural course of LMH are discussed, emphasizing the distinction between different LMH subtypes based on optical coherence tomography findings. While LMH is often asymptomatic and benign, surgical intervention may be considered for cases with progressive symptoms. Surgical techniques involving pars plana vitrectomy and epiretinal membrane peeling are explored, along with considerations for preserving the internal limiting membrane in cases with lamellar hole-associated epiretinal proliferation (LHEP). Outcomes and challenges associated with LMH surgery are examined, highlighting the variability in visual improvements and potential postoperative complications including the development of full-thickness macular hole.