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INFLUENCE OF INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE ON THE OUTER RETINAL LAYER STRUCTURES AFTER A LARGE MACULAR HOLE SURGERY

Iwasaki, Masanori, MD; Kinoshita, Takamasa, MD, PhD; Miyamoto, Hirotomo, MD; Imaizumi, Hiroko, MD, PhD

doi: 10.1097/IAE.0000000000002209
Original Study: PDF Only

Purpose: To examine the influence of inverted internal limiting membrane (ILM) flap technique on the outer retinal layer structures after macular hole (MH) surgery.

Methods: We included 24 eyes of 24 patients who underwent vitrectomy for large MHs (≥400 µm) with successful MH closure and observed for at least 6 months. Fourteen eyes were treated with inverted ILM flap technique (inverted group) and 10 with conventional ILM peeling (ILMP group). We evaluated the postoperative recovery rate of the external limiting membrane and ellipsoid zone and the best-corrected visual acuity.

Results: The postoperative recovery rates of the external limiting membrane and ellipsoid zone in the inverted group were lower than those in the ILMP group (21.4 vs. 70.0%, P = 0.024; 0 vs. 30.0, P = 0.059, respectively). The external limiting membrane recovery period in the inverted group was significantly longer than that in the ILMP group (11.0 ± 1.7 vs. 3.4 ± 2.8 months, P = 0.015). The best-corrected visual acuity change (letters) in the inverted group was significantly smaller than that in the ILMP group (9.0 vs. 22.5, P = 0.040).

Conclusion: The poorer anatomical and visual results associated with inverted ILM flap compared with ILM peeling suggest the limitation of the ILM flap technique to repair refractory MHs.

Twenty-four eyes underwent vitrectomy for large macular holes: 14 eyes with inverted internal limiting membrane flap technique and 10 with internal limiting membrane peeling. The external limiting membrane recovery rate and best-corrected visual acuity change were significantly smaller in the inverted internal limiting membrane group than in the internal limiting membrane peeling group (21.4% vs. 70.0%; 9.0 letters vs. 22.5 letters, respectively).

Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.

Reprint requests: Masanori Iwasaki, MD, Department of Ophthalmology, Sapporo City General Hospital, 1-1, Kita 11-jo Nishi 13-chome, Chuo-ku, Sapporo 060-8604, Japan; e-mail: iwasakicom@yahoo.co.jp

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

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© 2018 by Ophthalmic Communications Society, Inc.