Internal Limiting Membrane Flap Techniques for the Repair of Large Macular Holes: a Short-Term Follow-up of Anatomical and Functional Outcomes.
BackgroundTo evaluate the technique of inverted internal limiting membrane (ILM) flaps for the management of large macular holes and autologous ILM free flaps for non-closing macular holes.Patients and methodsAll macular holes were treated with pars plana vitrectomy and dual blue assisted ILM flap technique. The inverted ILM flap was created as a primary procedure for large macular holes (diameter > 400 µm). On the other hand, the free ILM flap technique was used as a secondary procedure for non-closing macular holes after failed initial standard procedure. SD-OCT images were taken to assess the anatomical outcome of surgery, while best corrected visual acuity (BCVA) was used to evaluate the functional outcome during a 2-month follow-up.ResultsAll patients underwent successful planned manipulation of the ILM flap. In seven patients/eyes, an inverted ILM flap was created, in three patients/eyes a free ILM flap translocation was performed. All patients achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in some cases as early as one month after surgery. Functionally, in comparison to baseline, most of the patients showed improvements in BCVA of 1 to 2 lines at the first postoperative follow-up visit.ConclusionsInverted ILM flaps for large macular holes and free flaps for non-closing macular holes appear to be a safe and effective approach, with favourable short-term anatomical and functional results.
Augenklinik, Kantonsspital Sankt Gallen, Switzerland (Head: Prof. Christophe Valmaggia).
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J
Guber
Augenklinik, Kantonsspital Sankt Gallen, Switzerland (Head: Prof. Christophe Valmaggia).
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C
Lang
Augenklinik, Kantonsspital Sankt Gallen, Switzerland (Head: Prof. Christophe Valmaggia).
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Valmaggia
D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012167:Retinal Perforations / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps / Q000637:transplantation*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*