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Tailored internal limiting membrane flap technique for primary macular hole
Jia-Horung Hung1,2, Yu-Harn Horng3, Hui-Chen Chu4
1Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Summary
The tailored internal limiting membrane (ILM) flap technique effectively closes primary full-thickness macular holes (MH). This surgical approach leads to significant visual acuity improvements in most patients, offering favorable anatomical and visual outcomes.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Hole Treatment
Background:
- Macular holes (MH) are a significant cause of vision loss.
- Surgical intervention is the primary treatment for full-thickness MH.
- The internal limiting membrane (ILM) flap technique has emerged as a promising surgical approach.
Purpose of the Study:
- To evaluate the anatomical and visual outcomes of the tailored ILM flap technique for primary full-thickness MH.
- To assess the efficacy of this specific ILM flap modification in MH repair.
Main Methods:
- Retrospective review of 19 eyes from 19 patients undergoing the tailored ILM flap technique.
- The technique involved incomplete circular perifoveal ILM peeling, trimmed to MH size, followed by fluid-gas exchange.
- Clinical characteristics and surgical outcomes were analyzed.
Main Results:
- Complete MH closure was achieved in all 19 eyes after a single surgery.
- Mean visual acuity improved significantly (0.9 to 0.4 logMAR, p < 0.0001).
- 78.9% of eyes achieved ≥20/40 visual acuity; outer retinal gliosis correlated with poorer outcomes, especially in large MHs (>400 μm).
Conclusions:
- The tailored ILM flap technique is effective for primary MH repair.
- This method yields favorable anatomical and visual results.
- Outer retinal gliosis is a negative prognostic factor for visual acuity post-surgery.
