Tailored internal limiting membrane flap technique for primary macular hole

Jia Horung Hung, Yu Harn Horng, Hui Chen Chu, Meng Syuan Li, Shwu Jiuan Sheu

Abstract

Purpose: To investigate the outcomes of primary full-thickness macular hole (MH) after surgical intervention with tailored internal limiting membrane (ILM) flap technique. Methods: Patients were reviewed for their clinical characteristics and surgical outcomes. The technique included incomplete circular peeling of the perifoveal ILM which was then trimmed according to the size of the MH. Fluid-gas exchange was done without further manipulation. Results: Nineteen eyes of 19 patients were included. The patients were in average 61 years old (range 41–83) and had an average follow-up period of 11.0 months. At baseline visit, minimal linear diameter of the MH was 311.6 μm (range 80–768). After a single surgery, the MH closed in all cases with improvement of mean visual acuity (from 0.9 to 0.4 logarithm of the minimum angle of resolution units, p < 0.0001, Wilcoxon signed-rank test). At the final visit, 15 (78.9%) eyes achieved a visual acuity ≥ 20/40. Outer retinal gliosis was found to be associated with less favorable postoperative visual acuity. Factors related to the formation of outer retinal gliosis were worse preoperative visual acuity and a large MH with a diameter > 400 μm. Conclusion: Tailored ILM flap technique is an effective method for favorable anatomical and visual outcomes for treatment of primary MH.

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All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Hung, Jia Horung ; Horng, Yu Harn ; Chu, Hui Chen ; Li, Meng Syuan ; Sheu, Shwu Jiuan. / Tailored internal limiting membrane flap technique for primary macular hole. In: Graefe's Archive for Clinical and Experimental Ophthalmology. 2020 ; Vol. 258, No. 4. pp. 759-766.