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- Title
Macular hole Delphi consensus statement (MHOST).
- Authors
Confalonieri, Filippo; Haave, Hanna; Binder, Susanne; Bober, Agnieszka Monika; Bragadottir, Ragnheidur; Bærland, Thomas; Faber, Rowan; Forsaa, Vegard; Gonzalez‐Lopez, Julio J.; Govetto, Andrea; Haugstad, Marta; Ivastinovic, Domagoj; Jenko, Neža Čokl; Nicoară, Simona Delia; Kaljurand, Kuldar; Kozak, Igor; Kvanta, Anders; Lytvynchuk, Lyubomyr; Nawrocka, Zofia Anna; Pajic, Sanja Petrovic
- Abstract
Purpose: To derive a Delphi method‐based consensus for the surgical management of Full Thickness Macular Hole (FTMH) and Lamellar Macular Hole (LMH). Methods: 37 expert VR surgeons from 21 mainly European countries participated in Delphi method‐based questionnaire for diagnosis and treatment of FTMHs and LMHs. Results: A total of 36 items were rated in round 1 by 37 participants, of which 10 items achieved consensus: intraoperative verification of PVD; clinical superiority of OCT‐based FTMH classification; practical ineffectiveness of ocriplasmin; circular 360° ILM peeling for small macular holes; use of regular surgical technique for the size of the hole in concomitant retinal detachment; performing complete vitrectomy; SF6 gas as preferred tamponade; cataract surgery if crystalline lens is mildly/moderately opaque; removal of both ILM and LHEP in LMH surgery. In round 2, 18 items with moderate consensus (45‐70% agreement) in round 1 were rated by 35 participants. Final consensus was reached in 35% of questions related to both diagnosis and surgical procedures. Conclusions: This Delphi study provides valuable information about the consensus/disagreement on different scenarios encountered during FTMH and LMH management as a guide tosurgical decision‐making. High rate of disagreement and/or variable approaches still exist for treating such relatively common conditions.
- Subjects
DELPHI (Extinct city); DELPHI method; VITRECTOMY; RETINAL surgery; CRYSTALLINE lens; CATARACT surgery; RETINAL detachment; OPERATIVE surgery
- Publication
Acta Ophthalmologica (1755375X), 2023, Vol 101, Issue 7, p815
- ISSN
1755-375X
- Publication type
Article
- DOI
10.1111/aos.15682