title: Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes.
abstract: PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery.ResultsNo significant differences were found in the pre- and postoperative BCVA at 1 and 3 months after surgery in either group (inverted ILM flap technique group, preoperatively 1.04±0.55, 1 month 0.95±0.30, 3 months 0.83±0.22; ILM peeling group, preoperatively 1.00±0.44, 1 month 1.05±0.38, 3 months 1.06±0.49; P>0.05, respectively). The postoperative BCVA at 6 months after surgery was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, 0.62±0.35; ILM peeling group, 1.02±0.41, P=0.045). The improvement in BCVA was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, -0.41±0.29; ILM peeling group, 0.02±0.36; P=0.021). The primary macular hole closure rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary reattachment rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary macular hole closure and reattachment rates were not significantly different in both groups (P=0.056, respectively).ConclusionThe inverted ILM flap technique is a useful procedure for MHRD in highly myopic eyes.
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Shiono
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Kogo
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Yomoda
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Munemasa
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Syoda
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Otake
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kurihara
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kitaoka
authors.affiliation: Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takagi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods