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INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE WITHOUT POSTOPERATIVE FACE-DOWN POSITIONING FOR MACULAR HOLE
Sunil Ruparelia1, Raman Tuli2, John S Y Park2
1Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Purpose:
To describe the outcomes of the inverted internal limiting membrane flap technique without postoperative face-down positioning for macular hole (MH) closure.
Methods:
This retrospective longitudinal study identified patients who had undergone surgical repair for large (>400 µm), idiopathic MHs and did not maintain face-down positioning postoperatively. Outcome measures included anatomical success, defined as confirmation of hole closure by the optical coherence tomography scan and functional success and defined as improved best-corrected visual acuity from baseline at the last follow-up.
Results:
Of the 63 eyes enrolled in the study, 94% patients (59 of 63) achieved anatomical success and 91% patients (57 of 63) achieved functional success. Fifteen (15) of these patients presented with a MH >600 µm. This subgroup achieved an anatomical success rate of 93% and a functional success rate of 87%. Statistically significant improvement in best-corrected visual acuity was demonstrated for all subgroups of MH size (P < 0.001).
Conclusion:
We report a high success rate of large, idiopathic MH closure with the inverted internal limiting membrane flap technique without postoperative face-down positioning. The results described in this study are favorable. However, larger studies with prospective design are warranted to explore this further.
