INVERTED INTERNAL LIMITING MEMBRANE FLAP FOR SMALL-SIZED (<250 µm) FULL-THICKNESS MACULAR HOLE: Anatomical and Functional Outcome. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Iuliano, Lorenzo; Corbelli, Eleonora; Bandello, Francesco; Codenotti, Marco
• Is Part Of: Retina. Volume 43:Issue 4(2023)
• Page Start: 547
• Page End: 554
• Publication Date: 2023-04
• Subjects: small macular hole -- intermediate macular hole -- inverted ILM flap -- cover technique -- external limiting membrane -- ellipsoid zone; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003728
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : The surgical repair of small-sized macular holes with ILM IF achieves successful anatomical and functional results, but it seem to delay the foveal structural repair and to gain an inferior foveal sensitivity compared with the standard technique. Abstract : Purpose: To compare the anatomical and functional outcome of small (&lt;250 µ m) and medium (250–400 µ m) full-thickness macular holes (FTMHs) treated with internal limiting membrane (ILM) inverted flap (IF) or with the standard technique. Methods: Retrospective longitudinal analysis of successfully operated eyes with small or intermediate FTMH. Outcome measures were best-corrected visual acuity (BCVA), microperimetric sensitivity (with fixation stability), and restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) at 6 months. Results: Fifty small and 50 intermediate eyes with FTMH were included, half of each group (25) treated with the standard technique, half with IF. BCVA increased in every subgroup, similarly within the same stage regardless the technique. Small FTMH treated with IF disclosed inferior foveal sensitivity at 6 months (20.79 ± 0.48 dB) compared with the standard technique (21.51 ± 0.79 dB; P = 0.0035). At 1 month, inferior rates of ELM (24%) and EZ (24%) restoration were also found, compared with the standard technique (56% ELM P = 0.0420; 64% EZ P = 0.0095). At 6 months, ELM and EZ were similarly restored. Conclusion: The surgical repair of small FMTH with ILM IF seem to delay the foveal structural repair and to gain an inferior foveal sensitivity compared to the standard technique.