Purpose: To analyze the anatomic and functional outcomes of lamellar macular hole (LMH) surgery. Patients and methods: This is a retrospective interventional cohort study of ninety patients with unilateral idiopathic LMH who underwent pars plana vitrectomy (PPV) with membrane peeling for LMH between 2014 and 2021. We evaluated the anatomic and functional success of PPV with membrane peeling for treating LMH, compared surgical outcomes between the two LMH subtypes (true LMH and epiretinal foveoschisis (ERMF)), and identified predictive factors for anatomical and functional success. Primary outcomes included final postoperative best-corrected visual acuity (BCVA) and LMH closure. Variables associated with final BCVA were assessed using a multiple linear regression model. Results: 51 subjects presented with ERMF, while 39 presented with true LMH. LMH closure occurred in 80 cases. True LMH cases had a lower rate of closure (true LMH closure rate: 76.9%, vs. ERMF closure rate: 94.2%, p=0.005) and were more at risk of developing a postoperative macular hole (p=0.008). A significant difference was observed between median [Q1, Q3] preoperative BCVA (0.42 [0.26, 0.61]) and final BCVA (0.31 [0.14, 0.48], p=0.024). True LMH without epiretinal proliferation (β=0.194, p=0.040) was associated with worse final BCVA in multivariate analysis. Conclusion: Results support the effectiveness of PPV as a treatment for LMH. True LMHs had worse anatomic outcomes than ERMFs.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of the Centre Universitaire d'Ophtalmologie - Centre de Recherche du Centre Hospitalier Universitaire de Quebec (CUO - CRCHU de Quebec) gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors.