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Vol 6 (2021): Continuous Publishing
Original paper
Published online: 2021-12-30
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Twelve-month follow-up after posterior 25G vitrectomy due to idiopathic full-thickness macular hole treated with “inverted ILM flap” technique

Michał Patyk1, Mariusz Kosatka1, Adam Kluś1, Janusz Sierdziński2, Marek Rękas1
·
Ophthalmol J 2021;6:274-280.
Affiliations
  1. Department of Ophthalmology, Military Institute of Medicine in Warsaw, Poland
  2. Department of Medical Informatics and Telemedicine of the Medical University of Warsaw, Poland

open access

Vol 6 (2021): Continuous Publishing
ORIGINAL PAPERS
Published online: 2021-12-30

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.

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.

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Keywords

idiopathic full-thickness macular hole; posterior vitrectomy; inverted ILM flap technique

About this article
Title

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

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Original paper

Pages

274-280

Published online

2021-12-30

Page views

5552

Article views/downloads

233

DOI

10.5603/OJ.2021.0047

Bibliographic record

Ophthalmol J 2021;6:274-280.

Keywords

idiopathic full-thickness macular hole
posterior vitrectomy
inverted ILM flap technique

Authors

Michał Patyk
Mariusz Kosatka
Adam Kluś
Janusz Sierdziński
Marek Rękas

References (10)
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  2. Ezra E, Gregor ZJ. Morfields Macular Hole Study Ggroup Report No. 1. Surgery for idiopathic full-thickness macular hole: two-year results of a randomized clinical trial comparing natural history, vitrectomy, and vitrectomy plus autologous serum: Morfields Macular Hole Study Group RAeport no. 1. Arch Ophthalmol. 2004; 122(2): 224–236.
  3. Ip MS, Baker BJ, Duker JS, et al. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography. Arch Ophthalmol. 2002; 120(1): 29–35.
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  7. Caicedo A, Espinosa-Heidmann DG, Piña Y, et al. Blood-derived macrophages infiltrate the retina and activate Muller glial cells under experimental choroidal neovascularization. Exp Eye Res. 2005; 81(1): 38–47.
  8. Mete M, Alfano A, Guerriero M, et al. Inverted internal limiting mambrane flap technique versus complete internal limiting membrane removal in myopic macular hole surgery: A Comparative Study. Retina. 2017; 37(10): 1923–1930.
  9. 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): 390–393.
  10. Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003; 87(8): 1015–1019.

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