Twelve-month follow-up after posterior 25G vitrectomy due to idiopathic full-thickness macular hole treated with “inverted ILM flap” technique

Abstract

Background: We conducted a prospective, follow-up study to analyze a long-term recovery process after posterior vitrectomy for idiopathic full-thickness macular hole. Material and methods: Sixty eyes were evaluated in 59 patients who underwent surgery for idiopathic fullthickness macular hole using posterior 25G vitrectomy with the “inverted ILM flap” technique from the beginning of 2013 to the end of 2014. In 55 eyes, posterior 25G phaco-vitrectomy with ILM peeling was performed using the “inverted ILM flap” technique with IOL implantation. In 5 pseudophakic eyes, posterior vitrectomy was performed with the technique as above. All patients were interviewed regarding the duration of the disease and pre- and postoperatively at intervals of 1, 3, 6, and 12 months. The following tests were performed: best-corrected visual acuity (BCVA), best-corrected near visual acuity (BCNVA), intraocular pressure (IOP) measurement, physical examination of the anterior and posterior segment of the eye, and spectral domain optical coherence tomography (SD-OCT). Results: The anatomical success in the study was 95%, and we achieved the improvement in visual acuity in 91.7% of the operated eyes. The visual acuity in the time interval before surgery and 12 months afterward improved from 0.1 to 0.29 and was statistically significant (p < 0.05). Shorter duration and smaller hole size were significant predictors of improved postoperative visual acuity. The U-type of the hole closure predisposed to the most significant improvement in visual acuity in patients. Conclusions: The obtained functional and anatomical results may confirm the effectiveness of posterior vitrectomy using the “inverted ILM flap” technique in treating idiopathic full-thickness macular holes. The observed sparce complications did not differ from the complication profile described by other authors.