Inverted internal limiting membrane insertion versus standard internal limiting membrane peeling for macular hole retinal detachment in high myopia: one-year study

Abstract

Compared to conventional ILM peeling, inverted ILM insertion has a higher MH closure rate and tendency of better postoperative VA in patients with MHRD.

Inverted Internal Limiting Membrane Flap Technique versus Internal Limiting Membrane Peeling for Vitrectomy in Highly Myopic Eyes with Macular Hole-Induced Retinal Detachment: An Updated Meta-Analysis

“…We have also shown that EZ restoration was better in the inverted ILM flap group than that of ILM peeling group. Our result is similar to that of another study where the inverted ILM flap technique resulted in a significantly better postoperative BCVA than did the ILM peeling technique [30].…”

“…e full text of the remaining 13 studies was evaluated; two studies had unqualified data, two did not meet the inclusion criteria, one was contextually irrelevant, and one contained data that could not be extracted. Eventually, seven studies [19,20,[26][27][28][29][30] with a total of 198 eyes (84 in the inverted ILM flap group and 114 in the ILM peeling group) were included in our meta-analysis. e characteristics of the seven studies are depicted in Table 1, and the results of their quality assessment are reported in Supplementary Table 1.…”

“…The lack of a significant difference at 6 months may be associated with the lower mean BCVA in the study of Chen and Yang [ 26 ]. A potential factor contributing to this heterogeneity was the staining dye; while Chen et al used indocyanine green (ICG) [ 26 ], the other three studies used brilliant blue G (BBG) [ 20 , 28 , 30 ]. A previous study also showed that ICG may have toxic effects on the retinal tissue, such as RPE atrophy [ 35 ].…”

“…However, there was a significant intergroup difference in the postoperative BCVA at 12 months after surgery, with no heterogeneity. This could be attributed to the use of BBG for ILM staining in all three included studies [ 28 – 30 ]. Glial cell proliferation induced by the inverted ILM flap, as proposed by Michalewska, produces an environment for photoreceptors to assume new positions in direct proximity to the fovea, thus resulting in improved postoperative visual acuity [ 16 ].…”

Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

“…In highly myopic eyes, a macular hole with retinal detachment (MHRD) can occur. Vitrectomy with removal of cortical vitreous and ILM and gas or silicone oil tamponade has become the standard of care for MHRD treatment [94]. Although anatomic reattachment can be achieved, the success rate of MH closure ranges from 50% to 70% and poor postoperatively visual acuity was reported [23, 95, 96].…”