Inverted Internal Limiting Membrane Flap For Large Traumatic Macular Holes

Shousha, Mohsen Ahmed Abou

doi:10.1097/md.0000000000002523

Cited by 26 publications

(18 citation statements)

References 27 publications

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“…Satisfactory results expanded the use of this technique to myopic MH, traumatic MH, repeat MH surgery, and optic disc maculopathy. 7,[15][16][17][18] Yamashita et al compared conventional ILM peeling and inverted flap technique in both medium-large (400-550µm) and extra-large (>550µm) MHs. They reported the closure rate of 95% and 100% in medium-large MHs by conventional and inverted flap techniques, respectively, and 88% and 100% in extra-large MHs although the difference between the two techniques was not significant.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison of Three Different Techniques of Inverted Internal Limiting Membrane Flap in Treatment of Large Idiopathic Full-Thickness Macular Hole</p>

Ghassemi¹,

Khojasteh²,

Khodabande³

et al. 2019

OPTH

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Purpose: To evaluate and compare three different techniques of inverted internal limiting membrane (ILM) flap in the treatment of large idiopathic full-thickness macular hole. Methods: In a comparative interventional case series, 72 eyes from 72 patients with large (> 400 µm) full-thickness macular hole were randomly enrolled into three different groups: group Ahemicircular ILM peel with temporally hinged inverted flap; group Bcircular ILM peel with temporally hinged inverted flap; and group Ccircular ILM peel with superior inverted flap. Best-corrected visual acuity (BCVA), anatomical closure rate, and ellipsoid zone (EZ) or external limiting membrane (ELM) defects were evaluated preoperatively, at week 1, and months 1, 3 and 6 after surgery. Results: There were 24 eyes in group A, 23 in group B, and 25 in group C. In all three groups, larger diameter macular hole was associated with worse preoperative visual acuity (r=0.625, P<0.001). Mean BCVA improved significantly in all three groups 6 months after surgery (0.91vs 0.55, p<0.001). 6 months after surgery, mean BCVA improved from 0.91 logMAR to 0.52±0.06 in group A, 0.90 to 0.53±0.06 in group B, and 0.91 to 0.55±0.11 in group C. In group A vs. B vs. C, improvement of BCVA was 0.380±0.04 vs. 0.383±0.04 vs. 0.368±0.11 logMAR, with no statistically significant difference between groups (P=0.660). The rate of successful hole closure was 87.5% vs. 91.3% vs. 100%. Although the closure rate was 100% in Group C (circular ILM peel with superiorly hinged inverted flap), this difference was not statistically significant (P=0.115). Conclusion: ILM peel with an inverted flap is a highly effective procedure for the treatment of large, full-thickness macular hole. Different flap techniques have comparable results, indicating that the technique can be chosen based on surgeon preference.

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Section: Discussionmentioning

confidence: 99%

<p>Comparison of Three Different Techniques of Inverted Internal Limiting Membrane Flap in Treatment of Large Idiopathic Full-Thickness Macular Hole</p>

Ghassemi¹,

Khojasteh²,

Khodabande³

et al. 2019

OPTH

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“…Like most studies, Hou and Jiang reported that 48 (89%) of the 54 eyes with TMH were successfully closed with visual acuity significantly improved after vitrectomy [ 39 ], but Yuan et al did not find significant improvement of visual function in the 18 (69.2%) of 26 cases of TMH that were successfully closed with vitrectomy and gas tamponade [ 31 ]. Literature reported outcomes of vitrectomy for cases series of TMH which are summarized in Table 3 [ 6 , 31 , 33 , 36 , 39 – 50 ]. This review shows that the anatomic success rate ranges from 45% to 100%, with a median of 92.5%; functional success (2 or more lines' improvement) rate ranges from 27% to 100%, with a median of 84%.…”

Section: Vitrectomymentioning

confidence: 99%

“…Shousha assessed the role of inverted ILM flap as a treatment option for large TMHs. In a prospective noncomparative study of 12 eyes with large TMHs (basal diameter of 1300–2800 um), a 100% closure rate and improvement of best-corrected visual acuity were achieved 6 to 9 months after the surgery [ 50 ].…”

Section: Vitrectomymentioning

confidence: 99%

Current Management of Traumatic Macular Holes

Liu

Grzybowski²

2017

Journal of Ophthalmology

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Traumatic macular hole (TMH) is not a rare clinical condition, especially in young population. Its prognosis is of complexity and uncertainty, with a relatively high rate of spontaneous closure in some cases. Modern vitrectomy surgery plays an important role in the treatment of TMH, although the functional outcomes may be compromised by the concomitant retinal pathologies. Decision-making about the time of vitrectomy, especially in pediatric patients, remains to be clarified further.

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“…In der Vergleichsstudie von Borʼi et al (2017) betrug der bestkorrigierte Visus 0,3 ± 0,25 in der Silikonöl-Gruppe und 0,2 ± 0,13 in der Gas-Gruppe [44]. Der invertierte ILM-Flap als adjuvante Maßnahme während der ppV hat bei 12 Augen zu einem anatomischen Verschluss von 100 % und zu einem medianen bestkorrigierten Visus von 20/100 geführt [45]. [44].…”

Section: Pars-plana-vitrektomieunclassified

“…Ikeda et al (2002) wiesen auf die Effektivität des ILM-Peelings mit ppV für TMF mit retinalen Falten hin [50]. In einer weiteren Studie führte der invertierte ILM-Flap als adjuvante Maßnahme in Kombination mit der ppV bei 12 Augen mit großen TMF (Durchmesser: 1300-2800 µm) zu einem anatomischen Verschluss von 100 % und zu einem medianen bestkorrigierten Visus von 20/100 [45].…”

Section: Vitrektomie Bei Kindernunclassified

Traumatisches Makulaforamen

Fiorentzis

Seitz

Viestenz

2018

Klin Monatsbl Augenheilkd

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The traumatic macular hole (TMH) is a rare complication of a blunt or an open injury of the globe and can lead to permanent loss of vision. The pathomechanism of TMH differs from that of the idiopathic macular hole (IMH). A sudden compression and expansion of the globe leads to vitreous traction, which can result in a TMH. The final visual acuity depends on the severity of the disruption of the photoreceptors and the retinal pigment epithelial cells. The posttraumatic approach is discussed controversially. A spontaneous closure and, therefore, a conservative approach should be considered in young patients with minor defects and good visual acuity without detachment of the posterior vitreous body. In these cases, it is advisable to wait for months. In the absence of adhesion at the edges of the hole and concomitant pathologies of the pigment epithelium, the spontaneous closure is improbable. In this case, a pars plana vitrectomy with removal of the vitreous and epiretinal membranes can lead to anatomical reconstruction and improvement of the visual acuity. The success of an operative intervention is complex and is associated with the experience of the surgeon as well as the characteristics of the trauma.

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Inverted Internal Limiting Membrane Flap For Large Traumatic Macular Holes

Abstract: Supplemental Digital Content is available in the text

Cited by 26 publications

References 27 publications

<p>Comparison of Three Different Techniques of Inverted Internal Limiting Membrane Flap in Treatment of Large Idiopathic Full-Thickness Macular Hole</p>

<p>Comparison of Three Different Techniques of Inverted Internal Limiting Membrane Flap in Treatment of Large Idiopathic Full-Thickness Macular Hole</p>

Current Management of Traumatic Macular Holes

Traumatisches Makulaforamen

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