Risk Factors for Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal in Patients with Open Flat Macular Hole

Ghoraba, Hammouda Hamdy; Mansour, Hosam Othman; Elsayed, Mohamed Ahmed Abdelhafez; Zaky, Adel Galal; Heikal, Mohamed Amin; Abdelfattah, Haithem; Elgouhary, Sameh Mohamed

doi:10.1159/000514495

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Inversion of the ILM flap might have served as a bridge, thus providing scaffolding for tissue proliferation which aids in the healing process of MH. Even though there was no difference in BCVA after surgery between the MH closure and nonclosure groups, MH closure reduced the risk of retinal detachment later in life [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

Zhao

Song

Tanumiharjo

et al. 2023

Eye

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Purpose To compare the efficacy of macular buckling (MB) alone against a combined internal limiting membrane (ILM) inversion flap for full-thickness macular hole (FTMH)-associated macular detachment (MD) in patients with high myopia. Methods This was a prospective interventional case series of patients with high myopia surgically treated with MB alone or combined with an inverted ILM flap for FTMH- associated MD. Best-corrected visual acuity (BCVA) at the 24-month postoperative follow-up, rate of initial retinal reattachment and macular hole closure were measured. Results A total of 62 eyes from 62 participants (33 in the MB group, 29 in the combination group) were studied. Postoperative BCVA improved significantly in both the combination group (P < 0.001) and the MB group (P = 0.027). The postoperative BCVA at 12 months (P = 0.021) and 24 months (P = 0.041) was significantly better in the combination group than in the MB group. The postoperative BCVA was not significantly different between the eyes with closed and unclosed MH at each follow-up time point (P > 0.05). In the combination group, we observed earlier retinal reattachment and closure of the MH as well as a higher rate of MH closure (82.8% vs. 66.7%) than in the MB group, although this difference was insignificant (P = 0.248). Conclusion MB combined with the ILM flap inversion technique achieved better postoperative BCVA and a higher success rate of MH closure than MB alone. We believe that combination surgery should be preferentially recommended.

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Section: Discussionmentioning

confidence: 99%

Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

Zhao

Song

Tanumiharjo

et al. 2023

Eye

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“…В исследовании Н. Ghoraba и соавт. [14], посвященном определению риска рецидива ОСМР, 124 пациентам во время витрэктомии СРЖ была аспирирована через МР с помощью иглы-флейты, затем произведена тампонада витреальной полости СМ. Среди 80 пациентов, которым было проведено удаление СМ, у 28 (35 %) человек сетчатка прилежала, и МР был закрыт.…”

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Surgical treatment of retinal detachment complicated by a macular hole

Fayzrakhmanov,

Shishkin,

Larina

et al. 2023

Rossijskij oftalʹmologičeskij žurnal

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Retinal detachment with a macular hole is a severe pathology leading to vision loss and disability of the patient. It is most frequently observed in myopes and causes severe damage of functional parameters of the retina. The pathogenesis of the disease is associated with tangential tractions of the inner limiting membrane and the posterior layers of the vitreous that affect the retina of the myopic eye. Modern ophthalmology uses a variety of approaches to the surgical treatment of the pathology. The final functional result primarily depends on how successful the macular hole closure and retinal reattachment are. To achieve this success, various techniques of subretinal fluid drainage can be used. The present literature review was conducted using the Pubmed search engine. We analyzed the articles published from 2000 to 2021. The analysis of research results showed the advantage of the peripheral method of drainage using a perfluoroorganic compound. This technique is relevant both in cases of the peripheral retinal tear and in subretinal fluid aspiration through the retinotomy. The peripheral method of drainage using a perfluoroorganic compound ensures a better functional outcome, which, in case of retinal detachment with a macular hole, mainly depends on the safety of the neuroreceptors of the central zone and the closure of the macular hole.

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Remote Functional Results Patients With Macular Hole and Rhegmatogenous Retinal Detachment Surgical Treatment With Different Volumes of Preservation of the Internal Limiting Membrane According to Microperimetry Data

Vaganova,

Кonovalova

2024

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Rationale: Macular hole is a defect of the retina in the foveolar zone. In combination with rhegmatogenous retinal detachment, this disease can lead to irreversible deterioration of visual functions and requires immediate surgical treatment. One of the trends in modern ophthalmic surgery is to increase the area of preservation of the internal limiting membrane during the macular hole blocking. Despite this, microperimetry data indicate the appearance of microscotomas at the point of peeling initiation and a general decrease in the photosensitivity of the retinal tissue in the membrane removal zone.Objective: to analyze the dynamics of changes in the retinal functional parameters of patients with macular hole and rhegmatogenous retinal detachment according to microperimetry data after surgical treatment in the late postoperative period.Methods: Data from 40 patients (40 eyes) diagnosed with macular hole and rhegmatogenous retinal detachment were prospectively studied. Patients in group 1 (20 patients, 20 eyes) underwent surgical treatment, including three-port 25G vitrectomy, perfluoroorganic compound, vitreous body sanitation at the periphery, and silicone tamponade. Membrane peeling was performed during the second operation to remove silicone. Patients in group 2 underwent vitrectomy, membrane staining under the perfluorine layer, membrane peeling with closure of the macular hole with an inverted flap, vitreous body sanitation during the first intervention. The operation was also completed with silicone tamponade. During the second intervention, silicone oil was removed from the vitreous cavity.Results: When comparing the light sensitivity index of the retinal tissue in the foveolar zone between the groups, a reliable difference in the indices by 1.2 times continued to persist up to one and a half years after the final stage of surgical treatment, there was a predominance of values in patients of the 1st group with a completely preserved membrane (p = 0.043 in comparison with the data of patients of the 2nd group). In three peripheral zones of the macula, during the long-term observation period up to one and a half years after surgery, the indices of patients of the 1st group prevailed by 1.5 times (p = 0.041 in comparison with the data of patients of the 2nd group).Conclusion: based on the analysis of the dynamics of the functional indices of the retina of patients after surgical treatment of macular hole in combination with rhegmatogenous retinal detachment, the refusal to perform membrane peeling on the detached retina during the first stage of surgical intervention allows to avoid aggressive mechanical trauma to the retinal tissue.

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Risk Factors for Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal in Patients with Open Flat Macular Hole

Cited by 3 publications

References 31 publications

Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

Surgical treatment of retinal detachment complicated by a macular hole

Remote Functional Results Patients With Macular Hole and Rhegmatogenous Retinal Detachment Surgical Treatment With Different Volumes of Preservation of the Internal Limiting Membrane According to Microperimetry Data

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