Abstract
We investigated the postoperative visual outcomes and morphological changes of the internal limiting membrane (ILM) flap, in patients who underwent the temporal inverted ILM flap technique for macular hole (MH). Between August 2018 and February 2020, 22 eyes of 22 patients with idiopathic or myopic MH who underwent vitrectomy with ILM flap were included in this study and followed-up for more than 6 months. Postoperative MH status, comparison of best-corrected visual acuity (BCVA) before and 6 months after surgery, changes in the ILM flap area at 1 and 6 months postoperatively, and the factors related to changes in ILM flap size, were analyzed. MH closure was achieved in all of the patients. The BCVA at 6 months postoperatively (0.18 ± 0.15) was significantly better than the preoperative BCVA of 0.63 ± 0.37 (P < 0.001, paired t test). The area of the ILM flap decreased significantly from 3.25 ± 1.27 mm2 at 1 month to 3.13 ± 1.23 mm2 at 6 months (P = 0.024, Wilcoxon signed-rank test). Two eyes showed an ILM flap contraction of more than 20%, and one eye required reoperation due to an increase in metamorphopsia and decreased visual acuity. Among age, sex, ILM flap area at 1 month, preoperative BCVA, and axial length, ILM flap contraction was correlated with patient age and ILM flap area. Although vitrectomy with the inverted ILM flap technique confers a good visual outcome, the ILM flap may contract in younger patients.
Highlights
We investigated the postoperative visual outcomes and morphological changes of the internal limiting membrane (ILM) flap, in patients who underwent the temporal inverted ILM flap technique for macular hole (MH)
We described a case of MH with macular pucker due to contraction of a single sheet of the ILM flap created from the temporal side after vitrectomy with silicone oil injection[12]
We examined the surgical outcomes and postoperative morphological changes of the ILM flap in patients who underwent MH coverage with a hinged ILM flap made on the temporal side after ILM peeling
Summary
We investigated the postoperative visual outcomes and morphological changes of the internal limiting membrane (ILM) flap, in patients who underwent the temporal inverted ILM flap technique for macular hole (MH). Vitrectomy with the inverted ILM flap technique confers a good visual outcome, the ILM flap may contract in younger patients. With the introduction of internal limiting membrane (ILM) peeling, both postoperative anatomical MH closure and improvement of visual function have been achieved with good and stable r esults[2]. We described a case of MH with macular pucker due to contraction of a single sheet of the ILM flap created from the temporal side after vitrectomy with silicone oil injection[12]. We investigated changes in postoperative MH status and visual acuity after vitrectomy for MH, using the inverted ILM flap technique. Changes in the ILM flap were compared between 1 month and 6 months after vitrectomy, and the clinical factors affecting the changes in the ILM flap were examined
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