Inverted internal limiting membrane flap technique in eyes with large idiopathic full-thickness macular hole: long-term functional and morphological outcomes.

Bleidißel, Nathalie; Friedrich, Julia; Klaas, Julian; Feucht, Nikolaus; Lohmann, Chris Patrick; Maier, Mathias

doi:10.1007/s00417-021-05082-7

2021

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Title:: Inverted internal limiting membrane flap technique in eyes with large idiopathic full-thickness macular hole: long-term functional and morphological outcomes.
Document type:: Journal Article
Author(s):: Bleidißel, Nathalie; Friedrich, Julia; Klaas, Julian; Feucht, Nikolaus; Lohmann, Chris Patrick; Maier, Mathias
Abstract:: PURPOSE: To investigate morphological and functional outcomes of the inverted internal limiting membrane (I-ILM) flap technique in large (≥ 400 μm) idiopathic full-thickness macular holes (FTMH) over a follow-up period of 12 months. METHODS: In this retrospective study, 55 eyes of 54 consecutive patients were enrolled. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT, Heidelberg, Spectralis) were performed preoperatively as well as 1, 3, 6, 9, and 12 months postoperatively. Special focus was put on the reintegration of outer retinal layers and the different ILM flap appearances. RESULTS: FTMH closure rate was 100% (55/55). BCVA significantly improved over the follow-up period of 12 months from 0.98 ± 0.38 LogMAR preoperatively to 0.42 ± 0.33 LogMAR at 12 months postoperatively (p < 0.001). There was no significant correlation between the three different ILM flap appearances and BCVA. Better preoperative BCVA, complete restoration of the external limiting membrane (ELM), higher macular hole index (MHI), and smaller MH base diameter were associated with higher improvement of BCVA. CONCLUSION: Our study highlights the favorable morphological and functional outcomes of the I-ILM flap technique in the short as well as in the long term. While complete ELM restoration revealed to be an important factor for improvement in BCVA, the different postoperative ILM flap appearances seem not to be related to BCVA.
Journal title abbreviation:: Graefes Arch Clin Exp Ophthalmol
Year:: 2021
Journal volume:: 259
Journal issue:: 7
Pages contribution:: 1759-1771
Fulltext / DOI:: doi:10.1007/s00417-021-05082-7
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/33512612
Print-ISSN:: 0721-832X
TUM Institution:: Klinik und Poliklinik für Augenheilkunde
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Augenheilkunde (Prof. Maier komm.)2021