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Internal limiting membrane translocation for refractory macular holes.
Joana Pires1, Jeroni Nadal2, Nuno Lourenço Gomes3
1Department of Ophthalmology, Centro Hospitalar do Baixo Vouga, Porto, Portugal.
The British Journal of Ophthalmology
|May 6, 2016
Summary
The internal limiting membrane (ILM) translocation technique successfully closed 91% of persistent macular holes after failed surgery. This method significantly improved visual acuity in patients with refractory macular holes.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Macular holes that remain open after pars plana vitrectomy (PPV) are challenging to treat.
- Previous surgery involving internal limiting membrane (ILM) peeling can complicate closure.
Purpose of the Study:
- To evaluate the efficacy of the ILM translocation technique for refractory macular holes.
- To assess visual acuity and anatomical outcomes in patients with persistent macular holes.
Main Methods:
- A prospective case series of 12 eyes with open macular holes post-PPV.
- ILM translocation involved harvesting and placing an ILM fragment into the macular hole.
- Outcomes included anatomical closure, visual acuity, and complications.
Main Results:
- Anatomical closure was achieved in 11 of 12 eyes (91%).
- A statistically significant improvement in best-corrected visual acuity (BCVA) was observed (p=0.008).
- Mean BCVA improved from 20/400 to 20/160, though only 16.7% achieved ≥20/63.
Conclusions:
- ILM translocation is effective for closing persistent idiopathic macular holes where primary surgery failed.
- The technique offers a viable option for complex macular hole cases.
