360° Inverted Internal Limiting Membrane Flap Technique for Idiopathic Macular Holes ≤ 250 Μm, > 250 and ≤ 400 Μm, and > 400 Μm
Graefe's archive for clinical and experimental ophthalmology(2022)
摘要
Purpose To study the functional and morphological results of the inverted internal limiting membrane (ILM) flap technique for the treatment of idiopathic macular holes (MHs) sized ≤ 250 µm, > 250 and ≤ 400 µm, and > 400 µm. Methods Retrospective, nonrandomized interventional study of 65 eyes with primary idiopathic MHs who underwent pars plana vitrectomy (PPV) with the inverted ILM flap technique. Closure rate, best-corrected visual acuity (BCVA), and integrity of external limiting membrane (ELM) and ellipsoid zone (EZ) were analyzed by optical coherence tomography (OCT). Results Total closure rate was 96.9% with 100% in the ≤ 250 µm group, 100% in the > 250 and ≤ 400 µm group, and 91.7% in the > 400 µm group. Mean BCVA significantly improved after treatment: from 0.7 to 0.3 LogMAR in the ≤ 250 µm group ( n = 15, p < 0.001), from 0.9 to 0.4 LogMAR in the > 250 and ≤ 400 µm group ( n = 26, p < 0.001), and from 1.0 to 0.5 LogMAR in the > 400 µm group ( n = 24, p < 0.001). A total of 16 patients had follow-up over 14 months: BCVA increased from 0.9 LogMAR preoperatively to 0.4 after 1 month ( p < 0.00001) and to 0.3 LogMAR after 14 months ( p = 0.03). A recovered ELM could be observed in 56.3% after 1 month and in 87.5% after 14 months. A recovered EZ could be observed in 18.8% after 1 month and in 68.8% after 14 months. Conclusion The study demonstrates a high closure rate with corresponding restitution of outer retinal layers. In addition to its importance for the treatment of MHs > 400 µm, the inverted ILM flap technique also appears to be effective and safe for the treatment of MHs < 400 µm. Trial registration: WHO: DRKS00021241
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关键词
360° inverted ILM flap technique,Cover technique,Small macular hole,Medium macular hole,Macular surgery,Closure rate,< 400 µm
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