Inverted internal limiting membrane flap for small-sized (

Abstract

To compare the anatomical and functional outcome of small (<250 μm) and medium (250-400 μm) full thickness macular holes (FTMHs) treated either with internal limiting membrane (ILM) inverted flap (IF) or with the standard technique. Retrospective longitudinal analysis of successfully operated eyes with small or intermediate FTMH. Outcome measures were best-corrected visual acuity (BCVA), microperimetric sensitivity (with fixation stability) and restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) at 6 months. Fifty small and 50 intermediate eyes with FTMH were included, half of each group (25) treated with the standard technique, half with IF. BCVA increased in every subgroup, similarly within the same stage regardless the technique. Small FTMH treated with IF disclosed inferior foveal sensitivity at 6 months (20.79±0.48 dB) compared to the standard technique (21.51±0.79 dB; p=0.0035). At 1-month, inferior rates of ELM (24%) and EZ (24%) restoration were also found, compared to the standard technique (56% ELM p=0.0420; 64% EZ p=0.0095). At 6 months, both ELM and EZ were similarly restored. The surgical repair of small FMTH with ILM inverted flap appear to delay the foveal structural repair and to gain an inferior foveal sensitivity compared to the standard technique.