title: Long-term surgical outcomes of the inverted internal limiting membrane flap technique in highly myopic macular hole retinal detachment.
abstract: BACKGROUND
  Pars plana vitrectomy (PPV) procedures are used for the surgical treatment of macular hole retinal detachment (MHRD) associated with high myopia. Re-detachment of the retina has been reported in MHRD associated with high myopia. Our aim was to evaluate the 1-year outcomes of vitrectomy, performed using an inverted internal limiting membrane (ILM) flap technique with gas tamponade, in five cases of MHRD associated with high myopia.
  
  
  METHODS
  We performed a retrospective review of medical records of five consecutive cases of highly myopic MHRD. The following postoperative data were collected: refractive error, best-corrected visual acuity, intraocular pressure, ophthalmic fundus examination findings, ocular coherence tomography at 1, 3, 6, and 12 months postoperatively; duration of the follow-up period; and intra- and postoperative complications. The primary endpoint of the study was the rate of postoperative retinal reattachment and macular hole (MH) closure. Paired t-tests were conducted to evaluate postoperative changes.
  
  
  RESULTS
  Mean visual acuity improved significantly (P = 0.008), with an improvement of ≥2 lines on LogMAR value gained in three of the five eyes. Retinal reattachment was maintained in all cases, with no cases of MH reopening identified over the mean follow-up period of 20.2 months. No complications were identified in any eye.
  
  
  CONCLUSIONS
  The inverted ILM flap technique and gas tamponade provided primary retinal reattachment and MH closure over the ≥12-month follow-up period.
authors.affiliation: Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura City, Chiba, 285-0841, Japan. taiga.kinoshita@med.toho-u.ac.jp.
authors.forename: Taiga
authors.identifier: http://orcid.org/0000-0003-4884-3384
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura City, Chiba, 285-0841, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Onoda
authors.affiliation: Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura City, Chiba, 285-0841, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Maeno
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D009887:Ophthalmoscopy; D012029:Refraction, Ocular; D012163:Retinal Detachment / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
keywords: Highly myopic macular hole retinal detachment; Inverted internal limiting membrane flap technique