Inverted internal limiting membrane flap technique in the surgical treatment of macular holes: 8-year experience

Silva, Nisa; Ferreira, Natália; Pessoa, Bernardete; Correia, Nuno; Beirão, João Melo; Meireles, Angelina

doi:10.1007/s10792-020-01600-4

Cited by 7 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We evaluated postoperative hole closure type in two types, according to sensory retinal status on OCT imaging. Some studies consider the presence of a foveal defect as unsuccessful closure; 11 , 12 however, we evaluated the cases as unsuccessful closure if the postoperative retinal edges remained elevated. We also considered the cases with flat retinal edges and a postoperative defect of the neurosensory retina on the fovea, as type 2 closure.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The restoration of foveal microstructure and the closure rate of macular hole have been reported higher in studies evaluating the inverted ILM flap technique in large macular holes. 11,12 Rishi and colleagues 28 reported two macular hole cases which underwent reoperation after type 2 closure and showed type 1 closure after reoperation. Kang and colleagues 6 reported two cases in type 2 closure group which have reopened and showed subretinal fluid after PPV and ILM peeling.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic factors affecting macular hole closure types

et al. 2021

View full text Add to dashboard Cite

Purpose: In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors. Materials and methods: In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed. Results: The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239). Conclusion: Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors affecting macular hole closure types

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Some vitreoretinal surgeons reserve this technique to treat large or myopic holes, whereas others use it routinely in all cases. 15 , 16 Theoretically, when the ILM fills the MH, it acts as a scaffold for the activation, proliferation, and migration of Müller cells, and, consequently, the production of neurotrophic and basic fibroblast growth factors during this process will contribute to hole closure. 17 When there is no closure of the hole edges, the ILM flap enables “flap closure” in macular holes that otherwise would remain open with bare retinal pigment epithelium after standard ILM peeling.…”

Section: Introductionmentioning

confidence: 99%

“… 30 Moreover, the inverted ILM flap technique has shown to be safe with few perioperative complications. 15 The use of autologous blood clot, viscoelastic devices, or perfluorocarbon liquid to prevent flap dislodgment during the air-fluid exchange has been investigated. 31 , 32 A novel technique of performing a semicircular single-layered ILM inverted flap assisted by sub-perfluorocarbon liquid injection of viscoelastic device provided good results, but the costs are increased.…”

Section: Introductionmentioning

confidence: 99%

Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?

Silva¹,

Ferreira²,

Michalewska³

et al. 2021

OPTH

Self Cite

View full text Add to dashboard Cite

Surgical treatment is generally necessary to repair full-thickness macular holes (FTMH). Although vitrectomy with or without internal limiting membrane (ILM) peeling remains the standard surgical technique, the inverted ILM flap procedure has increasingly assumed a role in the primary surgical repair of FTMHs. Some vitreoretinal surgeons reserve this technique to treat large or myopic holes, whereas others use it routinely in all cases. This paper is a comprehensive review of the current scientific evidence on the anatomical and functional outcomes of the inverted ILM flap technique in the repair of macular holes, following the International Vitreomacular Traction Study (IVTS) group classification.

show abstract

Visual improvement and regeneration of retinal layers in eyes with small, medium, and large idiopathic full-thickness macular holes treated with the inverted internal limiting membrane flap technique over a period of 12 months

Bleidißel

Friedrich

Feucht³

et al. 2022

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose This study aims to compare the improvement of best-corrected visual acuity (BCVA) and the reduction in defect length of external limiting membrane (ELM) and ellipsoid zone (EZ) in small ($$<$$ < 250 μm), medium ($$\ge$$ ≥ 250 μm), and large ($$\ge$$ ≥ 400 μm) full-thickness macular holes (FTMH) treated with inverted internal limiting membrane (I-ILM) flap technique over a follow-up period of 12 months. Methods Ninety-one eyes of 87 patients were enrolled in this retrospective study. BCVA and spectral-domain optical coherence tomography (SD-OCT) were conducted preoperatively as well as after 1, 3, 6, 9, and 12 months postoperatively. The defect length of the ELM and the EZ was measured using the caliper tool at each follow-up time point. Results BCVA improved significantly in the group of small, medium, and large FTMH over the time of 12 months, whereby the improvement did not depend on FTMH size over 9 months. Only after 12 months, large FTMH showed significantly higher BCVA improvement compared to small and medium FTMH. The closure rate was 100% (91/91). The defect length of ELM and EZ reduced continuously over the period of 12 months. There was a significant correlation between defect length of ELM and EZ with postoperative BCVA. Conclusion The I-ILM flap technique has very good morphological and functional outcomes in small, medium, and large FTMH over a long-time period, indicating that it can be considered as a treatment option in small and medium FTMH. The defect length of ELM and EZ is directly connected to postoperative BCVA.

show abstract

Inverted internal limiting membrane flap technique in the surgical treatment of macular holes: 8-year experience

Cited by 7 publications

References 27 publications

Prognostic factors affecting macular hole closure types

Prognostic factors affecting macular hole closure types

Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?

Visual improvement and regeneration of retinal layers in eyes with small, medium, and large idiopathic full-thickness macular holes treated with the inverted internal limiting membrane flap technique over a period of 12 months

Contact Info

Product

Resources

About