3 years ago

INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE VERSUS COMPLETE INTERNAL LIMITING MEMBRANE REMOVAL IN MYOPIC MACULAR HOLE SURGERY: A Comparative Study

INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE VERSUS COMPLETE INTERNAL LIMITING MEMBRANE REMOVAL IN MYOPIC MACULAR HOLE SURGERY: A Comparative Study
Prigione, Guido, Pertile, Grazia, Polito, Antonio, Sartore, Mauro, Alfano, Alessandro, Guerriero, Massimo, Mete, Maurizio
Purpose: To compare the results of vitrectomy with complete internal limiting membrane (ILM) removal and inverted ILM flap in the treatment of myopic macular hole (MMH). Methods: Seventy eyes of 68 patients with MMH undergone pars-plana vitrectomy (PPV) with either complete ILM removal (n = 36, Group 1) or inverted ILM flap technique (n = 34, Group 2) were included in the study. Outcomes measured were the rate of MMH closure assessed by optical coherence tomography (OCT) and visual acuity (BCVA) at six months. Results: Closure of MMH was achieved in 22 cases of Group 1 (61%) and in 32 cases of Group 2 (94%). Surgical failure was reported in 14 cases of Group 1 (39%) and in one case of Group 2 (3%). Average best-corrected visual acuity (BCVA) changed from 0.60 to 0.58 in Group 1 (P = 0.329) and from 0.70 to 0.39 in Group 2 (P < 0.01). Logistic regression analysis showed that inverted ILM flap technique was associated with 22 times higher probability of anatomic success, regardless of the MMH diameter. Conclusion: Inverted ILM flap should be preferred to complete ILM removal for the treatment of MMH. The outcomes reported with this technique were better than any other technique described until now.
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