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Double Internal Limiting Membrane Insertion for Macular Hole-Associated Retinal Detachment.

San-Ni Chen1,2, Chung-May Yang3,4

  • 1Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan.

Journal of Ophthalmology
|August 29, 2017
PubMed
Summary

A novel double internal limiting membrane (ILM) insertion technique successfully sealed macular holes (MH) associated with retinal detachment (RD) in highly myopic eyes, promoting retinal reattachment.

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Microsurgery

Background:

  • Macular holes (MH) in highly myopic eyes with associated retinal detachment (RD) present unique surgical challenges.
  • Standard surgical techniques may have limitations in achieving successful closure and retinal reattachment.

Purpose of the Study:

  • To describe and evaluate a modified technique of internal limiting membrane (ILM) insertion for MH-associated RD in highly myopic eyes.
  • To assess the efficacy and safety of this novel ILM insertion method.

Main Methods:

  • Pars plana vitrectomy with fovea-sparing ILM peeling was performed in nine eyes.
  • A double ILM insertion technique, utilizing an inverted perifoveal ILM and a free ILM flap, was employed.
  • Air-fluid exchange was used to stabilize the ILM plug within the macular hole.

Main Results:

  • Despite minor ILM tearing in two eyes during preparation, the double ILM insertion successfully stabilized the ILM plug in all cases.
  • The macular hole was sealed, and the retina was reattached in all nine eyes postoperatively.
  • The modified technique demonstrated high efficacy in achieving anatomical success.

Conclusions:

  • Double ILM insertion offers a secure method for closing macular holes associated with retinal detachment, particularly in complex cases.
  • This technique may be especially beneficial when insufficient perifoveal ILM is available for standard procedures.
  • The study provides evidence for a promising surgical approach in managing challenging myopic macular hole retinal detachments.