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INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR SURGICAL REPAIR OF MYOPIC MACULAR HOLES

Michalewska, Zofia MD, PhD*; Michalewski, Janusz MD, PhD*; Dulczewska-Cichecka, Karolina MD; Nawrocki, Jerzy MD, PhD*

doi: 10.1097/IAE.0000000000000042
Original Study

Purpose: To present the anatomical and functional results of vitrectomy with the “inverted internal limiting membrane flap technique” in myopic macular holes without retinal detachment.

Methods: A prospective interventional study of 19 myopic eyes with a spherical equivalent >−6 diopters with macular holes in 18 consecutive patients. Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measure was visual outcome and macular hole closure rate.

Results: Mean visual acuity improved from 1.2 logMAR to 0.56 logMAR. We confirmed the closure of the macular hole with spectral domain optical coherence tomography in all cases. The closure of the macular hole began in the inner retinal layers, and the architecture gradually filled with tissue. Photoreceptor and external limiting membrane defects improved during the first 12 months after surgery.

Conclusion: Vitrectomy with the inverted internal limiting membrane flap technique may be an effective addition to surgical options for treating myopic macular holes. Spectral domain optical coherence tomography images confirm that the process of foveal architectural repair after this surgery continues over at least a 12-month period.

The inverted internal limiting membrane technique was effective in closing myopic macular holes in this consecutive surgical series, and in improving visual acuity.

*Department of Ophthalmology, Ophthalmic Clinic Jasne Blonia, Lodz, Poland; and

Department of Ophthalmology, III Municipal Hospital K. Jonscher, Lodz, Poland.

Reprint requests: Zofia Michalewska, MD, PhD, Klinika Okulistyczna “Jasne Blonia,” ul. Rojna 90, Lodz 91-162, Poland; e-mail: zosia_n@yahoo.com

Paper presented at the Vail Vitrectomy Meeting, 2013.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.