Vitrectomy with Internal Limiting Membrane Repositioning and Autologous Blood for Macular Hole Retinal Detachment in Highly Myopic Eyes

Lai, Chi-Chun; Chen, Yen‐Po; Wang, Nan-Kai; Chuang, Lan-Hsin; Liu, Laura; Chen, Kuan‐Jen; Hwang, Yih‐Shiou; Wu, Wei‐Chi; Chen, Tun-Lu

doi:10.1016/j.ophtha.2015.05.040

Cited by 125 publications

(106 citation statements)

References 44 publications

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“…An important problem is the possibility of the ILM flap moving away from the hole opening in the inverted ILM flap technique. Recently, Lai et al 32 have introduced the novel technique of using autologous blood clots to stabilize and seal ILM flaps. That technique has shown high anatomic success rates and only requires patients with MHRD to remain in a facedown position for a short time postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…That technique has shown high anatomic success rates and only requires patients with MHRD to remain in a facedown position for a short time postoperatively. Lai et al 32 found that blood clots seal the holes after application and that the blood components and growth factors also facilitate healing. However, our study showed excellent anatomic success rates without the use of autologous blood clots.…”

Section: Discussionmentioning

confidence: 99%

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Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Sasaki

Shiono

Kogo

et al. 2016

Eye

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PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery.ResultsNo significant differences were found in the pre- and postoperative BCVA at 1 and 3 months after surgery in either group (inverted ILM flap technique group, preoperatively 1.04±0.55, 1 month 0.95±0.30, 3 months 0.83±0.22; ILM peeling group, preoperatively 1.00±0.44, 1 month 1.05±0.38, 3 months 1.06±0.49; P>0.05, respectively). The postoperative BCVA at 6 months after surgery was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, 0.62±0.35; ILM peeling group, 1.02±0.41, P=0.045). The improvement in BCVA was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, –0.41±0.29; ILM peeling group, 0.02±0.36; P=0.021). The primary macular hole closure rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary reattachment rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary macular hole closure and reattachment rates were not significantly different in both groups (P=0.056, respectively).ConclusionThe inverted ILM flap technique is a useful procedure for MHRD in highly myopic eyes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Sasaki

Shiono

Kogo

et al. 2016

Eye

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“…Several methods have been proposed to increase the MH closure rate after vitrectomy with internal limiting membrane (ILM) peeling, such as inverted epiretinal ILM flap [3], inverted ILM flap insertion [4] with or without blood coverage of the hole [5], temporal, or superior single-layer inverted ILM flap [6, 7]. Making an epiretinal flap to cover the hole or creating ILM flaps around the MH to insert into the hole may be technically demanding, and ILM flaps with an appropriate size and shape cannot always be created in a staphylomatous eye with epiretinal membrane and RD.…”

Section: Introductionmentioning

confidence: 99%

Multiple Free Internal Limiting Membrane Flap Insertion in the Treatment of Macular Hole-Associated Retinal Detachment in High Myopia

2018

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Purpose: The aim of this paper was to evaluate the efficacy of multiple free internal limiting membrane (ILM) flap insertion in the management of macular hole-associated retinal detachment in high myopia. Procedures: Eyes receiving operation for macular hole-associated retinal detachment were retrospectively recruited. Those in the study group received ILM peeling and multiple free ILM flap insertion, while those in the control group received ILM peeling only. Postoperative anatomical outcomes and best-corrected visual acuity were compared between the 2 groups. Results: Twenty-seven eyes of 27 patients were recruited in this study (13 in the study group, 14 in the control group). After the operation, the retina was reattached in all cases in both groups. The macular hole closure rate was 100% in the study group but only 42.9% in the control group (adjusted p < 0.001). The eyes in the study group had better visual improvement (logMAR –0.58 ± 0.43) than those in the control group (logMAR –0.31 ± 0.50) with borderline significance (adjusted p = 0.078). Conclusions: For macular hole-associated retinal detachment in highly myopic eyes, the multiple free ILM flap insertion technique offers an effective way to close macular holes. Whether this result also means better visual outcome remains to be seen.

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“…Firstly, while performing fluid-gas exchange with subretinal fluid (SRF) drainage after the inverted ILM insertion, does the MH defect become enlarged with a free-floating ILM flap? Lai et al suggested that SRF be maintained without intentional drainage, and that autologous blood clot be further used to stabilize and seal ILM flaps [10]. Although the SRF could be maintained for a certain amount of time, the fluid was eventually absorbed with improved VA. Secondly, can the outcomes be applied to a longer follow-up period?…”

mentioning

confidence: 99%

ILM peeling in macular hole retinal detachment: insert or not?

Lai

2018

Graefes Arch Clin Exp Ophthalmol

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Vitrectomy with Internal Limiting Membrane Repositioning and Autologous Blood for Macular Hole Retinal Detachment in Highly Myopic Eyes

Cited by 125 publications

References 44 publications

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Multiple Free Internal Limiting Membrane Flap Insertion in the Treatment of Macular Hole-Associated Retinal Detachment in High Myopia

ILM peeling in macular hole retinal detachment: insert or not?

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