nach oben

Spektrum der Augenheilkunde

Erschienen in:

23.02.2022 | original article

ILM peeling with ILM flap transposition vs. classic ILM peeling for small and medium macula holes—a prospective randomized trial

verfasst von: Christoph Leisser, MD, Manuel Ruiss, Caroline Pilwachs, Oliver Findl

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Summary

Background

The aim of the present study was to compare macular hole closure rates of patients with small and medium-sized macular holes who underwent vitrectomy with internal limiting membrane (ILM) peeling combined with ILM flap transposition over the macular hole, compared with classic ILM peeling.

Methods

This prospective randomized trial was designed as a pilot study with two groups: ILM peeling with ILM flap transposition over the macular hole vs. classic ILM peeling.

Results

Among 20 patients recruited, complete analysis could be performed for 16 patients. The macular hole closure rates were 100% in both groups, without significant differences with respect to postsurgical subfoveal hyporeflective zones (p = 1.0, Fisher’s exact test), postsurgical visual acuity (p = 0.7, t-test), and postsurgical irregularities of the ellipsoid zone (p = 1.0, Fisher’s exact test).

Conclusion

Vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole and classic ILM peeling are both successful methods for the repair of macular holes of small and medium size and are associated with comparable outcomes.

Vorheriger Artikel Sustained impact of COVID-19 on primary retinal detachment repair in a tertiary eye hospital from March to December 2020

Nächster Artikel Predictive value of macular hole indices for vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole on macular hole closure

Steel DH, Lotery AJ. Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment. Eye (Lond). 2013;27:S1–21. https://doi.org/10.1038/eye.2013.212.CrossRef

Sebag J, Gupta P, Rosen RR, et al. Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy. Trans Am Ophthalmol Soc. 2007;105:121–9.

Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991;109:654–9. https://doi.org/10.1001/archopht.1991.01080050068031.CrossRef

Eckardt C, Eckardt U, Groos S, et al. Entfernung der Membrana limitans interna bei Makulalöchern. Klinische und morphologische Befunde. Ophthalmologe. 1997;94:545–51. https://doi.org/10.1007/s003470050156.CrossRef

Park DW, Sipperley JO, Sneed SR, et al. Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology. 1999;106:1392–7. https://doi.org/10.1016/S0161-6420(99)00730-7.CrossRef

Brooks HL Jr.. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology. 2000;107:1939–48. https://doi.org/10.1016/s0161-6420(00)00331-6.CrossRef

Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 2010;117:2018–25. https://doi.org/10.1016/j.ophtha.2010.02.011.CrossRef

Michalewska Z, Michalewski J, Dulczewska-Cichecka K, et al. Temporal inverted internal limiting membrane flap technique versus classic inverted internal limiting membrane flap technique: a comparative study. Retina. 2015;35:1844–50. https://doi.org/10.1097/IAE.0000000000000555.CrossRef

Shin MK, Park KH, Park SW, et al. Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery. Retina. 2014;34:1905–10. https://doi.org/10.1097/IAE.0000000000000339.CrossRef

10.

Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120:2611–9. https://doi.org/10.1016/j.ophtha.2013.07.042.CrossRef

11.

Shiode Y, Morizane Y, Matoba R, et al. The role of inverted internal limiting membrane flap in macular hole closure. Invest Ophthalmol Vis Sci. 2017;58:4847–55. https://doi.org/10.1167/iovs.17-21756.CrossRef

12.

Vogt D, Haritoglou C, Mautone L, et al. Premacular cells as source of neurotrophic factors in idiopathic macular holes. Curr Eye Res. 2020;45:1395–402. https://doi.org/10.1080/02713683.2020.1752389.CrossRef

13.

Leisser C, Hirnschall N, Döller B, et al. Internal limiting membrane flap transposition for surgical repair of macular holes in primary surgery and in persistent macular holes. Eur J Ophthalmol. 2018;28:225–8. https://doi.org/10.5301/ejo.5001037.CrossRef

14.

Leisser C, Palkovits S, Hirnschall N, et al. One-year results after internal limiting membrane flap transposition for surgical repair of macular holes with respect to microperimetry. Ophthalmic Res. 2019;61:83–7. https://doi.org/10.1159/000489458.CrossRef

15.

Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003;87:1015–9. https://doi.org/10.1136/bjo.87.8.1015.CrossRef

16.

Steel DH, Donachie PHJ, Aylward GW, BEAVRS Macular hole outcome group, et al. Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort. Eye (Lond). 2021;35:316–25. https://doi.org/10.1038/s41433-020-0844-x.CrossRef

17.

Gekka T, Watanabe A, Ohkuma Y, et al. Pedicle internal limiting membrane transposition flap technique for refractory macular hole. Ophthalmic Surg Lasers Imaging Retina. 2015;46:1045–6. https://doi.org/10.3928/23258160-20151027-10.CrossRef

18.

Morizane Y, Shiraga F, Kimura S, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes. Am J Ophthalmol. 2014;157:861–869.e1. https://doi.org/10.1016/j.ajo.2013.12.028.CrossRef

19.

Casini G, Mura M, Figus M, et al. Inverted internal limiting membrane flap technique for MacUlar hole surgery without extra manipulation of the flap. Retina. 2017;37:2138–44. https://doi.org/10.1097/IAE.0000000000001470.CrossRef

20.

Rossi T, Gelso A, Costagliola C, et al. Macular hole closure patterns associated with different internal limiting membrane flap techniques. Graefes Arch Clin Exp Ophthalmol. 2017;255:1073–8. https://doi.org/10.1007/s00417-017-3598-9.CrossRef

21.

Essex RW, Kingston ZS, Moreno-Betancur M, Australian and New Zealand Society of Retinal Specialists Macular Hole Study Group, et al. The effect of postoperative face-down positioning and of long- versus short-acting gas in macular hole surgery: results of a registry-based study. Ophthalmology. 2016;123:1129–36. https://doi.org/10.1016/j.ophtha.2015.12.039.CrossRef

22.

Baumann C, Dervenis N, Kirchmair K, et al. Functional and morphological outcomes of the inverted internal limiting MEMBRANE flap technique IN small-sized and medium-sized MACULAR holes 〈400 µm. Retina. 2021;41:2073–8. https://doi.org/10.1097/IAE.0000000000003160.CrossRef

23.

Chou HD, Liu L, Wang CT, et al. Single-layer inverted internal limiting membrane flap versus conventional peel for small- or medium-sized full-thickness macular holes. Am J Ophthalmol. 2021;235:111–9. https://doi.org/10.1016/j.ajo.2021.08.016.CrossRef

Titel: ILM peeling with ILM flap transposition vs. classic ILM peeling for small and medium macula holes—a prospective randomized trial
verfasst von: Christoph Leisser, MD
Manuel Ruiss
Caroline Pilwachs
Oliver Findl
Publikationsdatum: 23.02.2022
Verlag: Springer Vienna
Erschienen in: Spektrum der Augenheilkunde / Ausgabe 1/2023
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI: https://doi.org/10.1007/s00717-022-00515-y