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Macular pucker formation after inverted internal limiting membrane flap technique: Two case reports
Keisuke Kanda1, Hiroshi Nakashima1, Kazuyuki Emi1
1Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, Osaka, Japan.
American Journal of Ophthalmology Case Reports
|February 7, 2022
Summary
Macular pucker can occur after inverted internal limiting membrane (ILM) flap surgery, even without silicone oil. Removing the ILM flap and proliferative tissue successfully treated the condition without recurrence.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- The inverted internal limiting membrane (ILM) flap technique is a standard treatment for refractory macular holes (MHs).
- Previous reports suggested macular pucker formation post-ILM flap surgery was linked to silicone oil use.
Observation:
- This study reports two cases of macular pucker developing after inverted ILM flap surgery performed without silicone oil.
- In both cases, visual acuity worsened postoperatively, with macular pucker associated with the ILM flap.
Findings:
- Histopathological examination of removed tissue revealed significant cellular proliferation between the internal limiting membranes.
- Macular pucker formation may occur independently of silicone oil in inverted ILM flap procedures.
Implications:
- Ophthalmologists should consider macular pucker as a potential complication of the inverted ILM flap technique, even without silicone oil.
- Surgical removal of the ILM flap and associated proliferative tissue can effectively resolve macular pucker and prevent recurrence.
