title: Inverted Internal Limiting Membrane Flap For Large Traumatic Macular Holes.
abstract: The aim of the study was to assess the role of inverted internal limiting membrane flap as a treatment option for large traumatic macular holes.This is a prospective noncomparative study in which 12 eyes with large traumatic macular holes (basal diameter of 1300-2800 μm) since 3 to 6 months were subjected to standard 23-gauge vitrectomy with removal of the posterior hyaloid, brilliant blue G (BBG)-assisted internal limiting membrane peeling in a circular fashion keeping it attached to the edge of the hole to create a flap. At the end of the surgery, air fluid exchange was done with inversion of the internal limiting membrane flap inside the macular hole using the soft tipped cannula and sulfur hexafluoride 20% as tamponade. The main follow-up measures are the best corrected visual acuity and the optical coherence tomography for 6 to 9 months.All the included eyes had a closed hole from the first week postoperative and along the follow-up period (6-9 months). The best corrected visual acuity improved from 20/2000 to 20/200 with a median of 20/400 preoperatively to 20/400 to 20/50 with a median of 20/100 at the end of follow-up period.Inverted internal limiting membrane flap is a good adjuvant to standard vitrectomy in the management of large traumatic macular holes that led to the 100% closure rate and improvement of best corrected visual acuity.
authors.affiliation: From the Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Mohsen Ahmed
authors.initials: MA
authors.lastname: Abou Shousha
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000601:surgery; D012167:Retinal Perforations / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D055815:Young Adult
references.citation: J Fr Ophtalmol. 1997;20(6):423-9
references.pmid: 9296038
references.citation: Retina. 1999;19(5):410-3
references.pmid: 10546936
references.citation: Retina. 1999;19(5):405-9
references.pmid: 10546935
references.citation: Invest Ophthalmol. 1969 Jun;8(3):290-301
references.pmid: 5772720
references.citation: Exp Eye Res. 2005 Jul;81(1):38-47
references.pmid: 15978253
references.citation: Acta Ophthalmol Scand. 2002 Feb;80(1):88-90
references.pmid: 11906311
references.citation: Am J Ophthalmol. 2013 Jul;156(1):125-131.e1
references.pmid: 23622567
references.citation: Am J Ophthalmol. 1997 Jun;123(6):837-9
references.pmid: 9535631
references.citation: Retina. 1996;16(5):451-2
references.pmid: 8912978
references.citation: Arch Ophthalmol. 1991 May;109(5):654-9
references.pmid: 2025167
references.citation: Arch Ophthalmol. 1997 Jul;115(7):929-30
references.pmid: 9230842
references.citation: Jpn J Ophthalmol. 1996;40(4):544-7
references.pmid: 9130060
references.citation: Ophthalmic Surg Lasers. 2001 Jul-Aug;32(4):308-15
references.pmid: 11475397
references.citation: Ophthalmology. 1998 Sep;105(9):1617-20
references.pmid: 9754166
references.citation: Am J Ophthalmol. 2002 Feb;133(2):230-5
references.pmid: 11812427
references.citation: Retina. 2014 Apr;34(4):664-9
references.pmid: 24263468
references.citation: Surv Ophthalmol. 1998 Mar-Apr;42(5):393-416
references.pmid: 9548570
references.citation: Retina. 1992;12(4):289-98
references.pmid: 1485013
references.citation: Am J Ophthalmol. 2003 Jul;136(1):197-9
references.pmid: 12834697
references.citation: Am J Ophthalmol. 2003 Apr;135(4):537-9
references.pmid: 12654374
references.citation: Retina. 1999;19(5):470-2
references.pmid: 10546953
references.citation: Ophthalmology. 2010 Oct;117(10):2018-25
references.pmid: 20541263
references.citation: Ophthalmic Epidemiol. 2006 Jun;13(3):209-16
references.pmid: 16854775
references.citation: Zhonghua Yan Ke Za Zhi. 2008 Sep;44(9):786-9
references.pmid: 19175156
references.citation: Br J Ophthalmol. 2012 Jul;96(7):1003-7
references.pmid: 22611137
references.citation: Ophthalmology. 1995 Dec;102(12):1840-5
references.pmid: 9098285
references.citation: Ophthalmology. 2001 May;108(5):853-7
references.pmid: 11320012
references.citation: Retina. 1997;17(5):372-7
references.pmid: 9355183
references.citation: Arch Ophthalmol. 1997 Sep;115(9):1210-1
references.pmid: 9298072