title: INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLES IN HIGH MYOPIA WITH AXIAL LENGTH ≥30 mm.
abstract: OBJECTIVE
  To evaluate the closure rate of macular holes in highly myopic eyes treated with the inverted internal limiting membrane flap technique.
  
  
  METHODS
  Retrospective study in 33 consecutive patients (33 eyes) with a myopic macular hole (axial length ≥30 mm) and no associated macular retinoschisis, undergoing 23-gauge pars plana vitrectomy combined with the inverted internal limiting membrane flap technique.
  
  
  RESULTS
  Mean initial logarithm of the minimum angle of resolution best-corrected visual acuity was 0.59 (range, 0.22-1.8) (Snellen fraction, 20/80). At the 1-month postoperative control visit, the macular hole was closed in all patients. Reopening of the hole occurred in 2 patients. Visual acuity improved in 13 patients (39.4%): final mean ETDRS (Early Treatment Diabetic Retinopathy Study) improvement was +80 letters, and logarithm of the minimum angle of resolution was 0.4 (20/50). Staphyloma with macular involvement was present in all patients. Dissociated optic nerve fiber layer was observed in 25 patients (75.7%) and was absent in 2 (6.1%); in the remaining 6 patients, the layer could not be assessed. Gliosis was found in 14 patients (42.4%).
  
  
  CONCLUSIONS
  Vitrectomy plus the inverted internal limiting membrane flap technique was effective for treating macular holes in eyes with axial length ≥30 mm and no associated retinoschisis.
authors.affiliation: *Instituto de Microcirugía Ocular (IMO), Barcelona, Spain; and †Department of Biostatistics, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Oleñik
authors.forename: José
authors.initials: J
authors.lastname: Rios
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateo
mesh_terms: D000368:Aged; D058452:Axial Length, Eye / Q000473:pathology*; D001485:Basement Membrane / Q000601:surgery*; D058450:Endotamponade; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D012167:Retinal Perforations / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride