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Comparative Study
. 2016 Oct 20;11(10):e0165068.
doi: 10.1371/journal.pone.0165068. eCollection 2016.

Comparison of the Inverted Internal Limiting Membrane Flap Technique and the Internal Limiting Membrane Peeling for Macular Hole with Retinal Detachment

Takehiro Matsumura  1 , Yoshihiro Takamura  1 , Takeshi Tomomatsu  1 , Shogo Arimura  1 , Makoto Gozawa  1 , Akira Kobori  2 , Masaru Inatani  1
Affiliations
Comparative Study

Comparison of the Inverted Internal Limiting Membrane Flap Technique and the Internal Limiting Membrane Peeling for Macular Hole with Retinal Detachment

Takehiro Matsumura et al. PLoS One. .

Abstract

Purpose: To evaluate the efficacy of the inverted internal limiting membrane (ILM) flap technique in vitrectomy for macular hole (MH) with retinal detachment (RD) compared with vitrectomy using ILM peeling.

Methods: A retrospective case series study was performed. Twenty-two eyes of 22 patients who underwent vitrectomy for MH with RD and followed-up more than 12 months after the surgery were included in this study. We retrospectively reviewed the medical records of patients who underwent vitrectomy with inverted ILM flap technique or vitrectomy with ILM peeling. Ten patients who had been treated vitrectomy with inverted ILM flap technique, and 12 patients who had been treated vitrectomy with ILM peeling were analyzed. We evaluated changes in best-corrected visual acuity (BCVA) before and after surgery, closing rates of MH, and retinal reattachment rates and compared between both groups.

Results: MH was closed and RD was reattached postoperatively in 9 eyes (90%) in the inverted ILM flap group. In the ILM peeling group, the MH was closed in 4 eyes (33.3%) and the retinas were reattached in 6 eyes (50%) after surgery. Significant improvement in BCVA after surgery (P = 0.0017) was only found in the inverted ILM flap group.

Conclusions: Higher rates of closed MH and retinal reattachment, and small but significant improvement in BCVA were found in the inverted ILM flap group. Based on our data, the inverted ILM flap technique may be useful in vitrectomy for MH with RD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Surgical photograph of the inverted internal limiting membrane flap around the macular hole-associated retinal detachment.
After brilliant blue G staining, the internal limiting membrane was peeled and inverted to cover the macular hole.
Fig 2
Fig 2. Changes in the preoperative and postoperative best-corrected visual acuities (BCVAs) of the eyes that underwent vitrectomy using the inverted internal limiting membrane flap technique for macular holes with retinal detachments.
The BCVAs were converted to the logarithm of the minimal angle of resolution (logMAR) units.
See this image and copyright information in PMC

References

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