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Spektrum der Augenheilkunde

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15.08.2022 | original article

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

verfasst von: PD Dr. Christoph Leisser, MD, Prof. Dr. Oliver Findl, MD, MBA

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 1/2023

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Summary

Background

Vitrectomy with peeling of the internal limiting membrane (ILM) represents the gold standard in treatment of full-thickness macular holes, and in large macular holes there is evidence that ILM flap techniques have the potential to offer even better results. The aim of the present study was to assess the possible predictive value of macular hole indices with respect to postsurgical macular hole closure after the first surgery for patients having undergone vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole for macular hole repair.

Methods

This retrospective study included patients with full-thickness macular holes having undergone vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole. The minimal and base diameters of the macular hole were measured and macular hole indices were calculated.

Results

From 52 patients who underwent vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole, 39 patients had an idiopathic macular hole, forming a subgroup large enough for statistical analysis. Postsurgical macular hole closure was achieved in 90% of patients after the primary surgery and in 97% of patients including a repeated surgery. Neither macular hole indices nor macular hole diameters were significant predictors for postsurgical macular hole closure after the first surgery.

Conclusion

Vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole resulted in high rates of macular hole closure, but neither macular hole indices nor macular hole diameters were predictors of success at the first surgery after vitrectomy with ILM peeling combined with ILM flap transposition.

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

Nächster Artikel Corneal biomechanical assessment via ocular response analyzer following intravitreal aflibercept therapy

Steel DH, Lotery AJ. Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment. Eye (Lond). 2013;27(Suppl 1):S1–S21. 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.

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(12):2611–9. https://doi.org/10.1016/j.ophtha.2013.07.042.CrossRef

Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991;109(5):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(8):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(7):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(10):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(10):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(9):1844–50. https://doi.org/10.1097/IAE.0000000000000555.CrossRef

10.

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(9):1905–10. https://doi.org/10.1097/IAE.0000000000000339.CrossRef

11.

Messmer EM, Heidenkummer HP, Kampik A. Ultrastructure of epiretinal membranes associated with macular holes. Graefes Arch Clin Exp Ophthalmol. 1998;236(4):248–54. https://doi.org/10.1007/s004170050072.CrossRef

12.

Yooh HS, Brooks HL Jr, Capone A Jr, et al. Ultrastructural features of tissue removed during idiopathic macular hole surgery. Am J Ophthalmol. 1996;122(1):67–75. https://doi.org/10.1016/s0002-9394(14)71965-8.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(2):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(2):83–7. https://doi.org/10.1159/000489458.CrossRef

15.

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(11):4847–55. https://doi.org/10.1167/iovs.17-21756.CrossRef

16.

Vogt D, Haritoglou C, Mautone L, et al. Premacular cells as source of neurotrophic factors in idiopathic macular holes. Curr Eye Res. 2020;45(11):1395–402. https://doi.org/10.1080/02713683.2020.1752389.CrossRef

17.

Leisser C, Ruiss M, Pilwachs C, Findl O. ILM peeling with ILM flap transposition vs. classic ILM peeling for small and medium macula holes—a prospective randomized trial. Spektrum Augenheilkd. 2022; https://doi.org/10.1007/s00717-022-00515-y.CrossRef

18.

Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003;87(8):1015–9. https://doi.org/10.1136/bjo.87.8.1015.CrossRef

19.

Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol. 2002;86(4):390–3. https://doi.org/10.1136/bjo.86.4.390.CrossRef

20.

Kusuhara S, Teraoka Escaño MF, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol. 2004;138(5):709–16. https://doi.org/10.1016/j.ajo.2004.04.063.CrossRef

21.

Ruiz-Moreno JM, Staicu C, Piñero DP, et al. Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol. 2008;92(5):640–4. https://doi.org/10.1136/bjo.2007.136176.CrossRef

22.

Rizzo S, Tartaro R, Barca F, et al. Internal limiting membrane peeling versus inverted flap technique for treatment of full-thickness macular holes: a comparative study in a large series of patients. Retina. 2018;38(Suppl 1):S73–S8. https://doi.org/10.1097/IAE.0000000000001985.CrossRef

23.

Baumann C, Kaye S, Iannetta D, et al. Effect of inverted internal limiting membrane flap on closure rate, postoperative visual acuity, and restoration of outer retinal layers in primary idiopathic macular hole surgery. Retina. 2020;40(10):1955–63. https://doi.org/10.1097/IAE.0000000000002707.CrossRef

24.

Chen G, Tzekov R, Jiang F, et al. Inverted ILM flap technique versus conventional ILM peeling for idiopathic large macular holes: a meta-analysis of randomized controlled trials. PLoS ONE. 2020;15(7):e236431. https://doi.org/10.1371/journal.pone.0236431.CrossRef

25.

BEAVRS Macular hole outcome group. Factors affecting anatomical and visual outcome after macular hole surgery: findings from a large prospective UK cohort. Eye (Lond). 2021;35(1):316–25. https://doi.org/10.1038/s41433-020-0844-x.CrossRef

26.

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(10):1045–6. https://doi.org/10.3928/23258160-20151027-10.CrossRef

27.

Morizane Y, Shiraga F, Kimura S, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes. Am J Ophthalmol. 2014;157(4):861–869.e1. https://doi.org/10.1016/j.ajo.2013.12.028.CrossRef

28.

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(11):2138–44. https://doi.org/10.1097/IAE.0000000000001470.CrossRef

29.

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(6):1073–8. https://doi.org/10.1007/s00417-017-3598-9.CrossRef

30.

Australian and New Zealand Society of Retinal Specialists Macular Hole Study Group. 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(5):1129–36. https://doi.org/10.1016/j.ophtha.2015.12.039.CrossRef

Titel: Predictive value of macular hole indices for vitrectomy with ILM peeling combined with ILM flap transposition over the macular hole on macular hole closure
verfasst von: PD Dr. Christoph Leisser, MD
Prof. Dr. Oliver Findl, MD, MBA
Publikationsdatum: 15.08.2022
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/s00717-022-00530-z