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Inverted internal limiting membrane-flap technique for large macular hole: a microperimetric study
Giancarlo Sborgia1, Alfredo Niro2, Alessandra Sborgia1,2
11Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy.
International Journal of Retina and Vitreous
|October 24, 2019
Summary
The inverted Internal Limiting Membrane (ILM)-flap technique effectively treats large macular holes (LMH), showing high closure rates and improved visual acuity. Preoperative macular sensitivity and fixation behavior predict surgical outcomes.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Diseases
Background:
- The inverted Internal Limiting Membrane (ILM)-flap technique may offer superior outcomes for large macular holes (LMH) compared to traditional ILM peeling.
- Assessing functional changes beyond visual acuity is crucial for understanding surgical approach benefits.
Purpose of the Study:
- To evaluate macular function and morphology one year after the inverted ILM-flap technique for LMH.
- To predict visual prognosis using microperimetry data.
Main Methods:
- Prospective, single-center study of 23 eyes with idiopathic LMH (400-1000 μm diameter).
- Vitrectomy with inverted ILM-flap technique and gas tamponade.
- Analysis of macular hole closure, best-corrected visual acuity (BCVA), macular sensitivity (MS), central macular sensitivity (CMS), and fixation behavior (BCEA) via microperimetry over 12 months.
Main Results:
- 98% macular hole closure rate achieved.
- Significant improvement in BCVA (20/230 to 20/59), MS, CMS, and BCEA (p < 0.01).
- Final BCVA correlated with macular hole size, preoperative MS, and 95%/99% BCEA (p < 0.05).
Conclusions:
- The inverted ILM-flap technique yields favorable morphologic and functional results for LMH.
- Preoperative macular sensitivity and bivariate contour ellipse area predict post-surgical visual acuity.
