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MACULAR HOLE CLOSURE OVER RESIDUAL SUBRETINAL FLUID BY AN INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE IN PATIENTS WITH MACULAR HOLE RETINAL DETACHMENT IN HIGH MYOPIA

Okuda, Tetsuhiko MD, PhD*; Higashide, Tomomi MD, PhD*; Kobayashi, Koh MD; Ikuno, Yasushi MD; Sugiyama, Kazuhisa MD, PhD*

Retinal Cases & Brief Reports: April 2016 - Volume 10 - Issue 2 - p 140–144
doi: 10.1097/ICB.0000000000000205
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Purpose: To describe the closure of a macular hole over residual subretinal fluid in patients with macular hole retinal detachment in high myopia who had been treated using an inverted internal limiting membrane flap technique.

Methods: Three patients with macular hole retinal detachment in high myopia underwent pars plana vitrectomy using the inverted internal limiting membrane flap technique. One patient received a silicone oil injection, and the other two patients received a long-acting gas injection at the end of the surgery. After surgery, spectral domain ocular coherence tomography examination was performed.

Results: In the patient with the silicone oil injection, spectral domain optical coherence tomography revealed that the macular hole was sealed with an inverted internal limiting membrane flap in the presence of subretinal fluid 1 day after surgery. The inner retinal layers gradually regained a more physiologic configuration over the residual subretinal fluid. In all patients, macular holes were completely closed over the subretinal fluid, which was gradually absorbed.

Conclusion: Using the inverted internal limiting membrane flap technique, macular holes were closed over residual subretinal fluid in patients with macular hole retinal detachment. The results indicate that reattachment of the retina may not be necessary for closure of macular holes.

The authors performed pars plana vitrectomy using an inverted internal limiting membrane flap technique for patients with highly myopic macular hole retinal detachment. The macular hole was closed with proliferation of tissue along the inverted internal limiting membrane, which bridged the macular hole in the presence of partially absorbed subretinal fluid.

*Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan; and

Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.

Reprint requests: Tetsuhiko Okuda, MD, PhD, Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan; e-mail: okuda@med.kanazawa-u.ac.jp

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

© 2016 by Ophthalmic Communications Society, Inc.