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Spotlight on the Internal Limiting Membrane Technique for Macular Holes: Current Perspectives
Tomaso Caporossi1,2, Matteo Mario Carlà1,2, Gloria Gambini1,2
1Ophthalmology Department, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome, 00168, Italy.
Clinical Ophthalmology (Auckland, N.Z.)
|April 14, 2022
Summary
Internal limiting membrane (ILM) management is crucial for macular hole (MH) surgery success. Innovations in ILM peeling techniques significantly improve anatomical closure rates, especially for large and recurrent MHs.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Pars plana vitrectomy is standard for macular hole (MH) repair.
- Internal limiting membrane (ILM) peeling enhances MH closure rates and prevents reopening.
Purpose of the Study:
- To review advancements in macular hole surgery since 2000.
- To analyze the evolving role of ILM management in MH repair.
Main Methods:
- Review of contemporary surgical techniques for MH repair.
- Analysis of ILM peeling modifications and their outcomes.
- Inclusion of techniques for large and recurrent MHs.
Main Results:
- ILM peeling improves anatomical closure rates for MHs, including large ones (>400 µm).
- Novel techniques like ILM inverted flaps achieve >90% closure rates for large MHs.
- Innovations for recurrent MHs show high anatomical success rates.
Conclusions:
- Macular hole surgery success has significantly increased since 2000.
- ILM management is a critical factor in achieving high success rates in MH surgery.
- Further research is ongoing for optimal ILM peeling strategies and functional outcomes.
