VISUAL OUTCOMES AFTER INTERNAL LIMITING MEMBRANE PEELING VERSUS FLAP IN THE CLOSURE OF FULL-THICKNESS MACULAR HOLES

Area of Science:

• Ophthalmology
• Retinal Surgery

Background:

• Full-thickness macular holes (FTMH) are a significant cause of vision loss.
• Surgical closure of FTMH aims to restore visual function.
• Internal limiting membrane (ILM) manipulation is a key step in FTMH repair.

Purpose of the Study:

• To compare the postoperative outcomes of internal limiting membrane peeling (ILMP) versus internal limiting membrane flap (ILMF) for FTMH closure.
• To evaluate differences in hole closure rates and visual acuity between the two techniques.

Main Methods:

• Retrospective chart review of FTMH patients undergoing pars plana vitrectomy with ILMP or ILMF.
• Data collected from January 2012 to October 2022 with a minimum 3-month follow-up.
• Primary outcome measures: FTMH closure rate and best-corrected visual acuity (BCVA) in logMAR.

Main Results:

• 130 eyes underwent ILMP and 30 eyes underwent ILMF, with no significant baseline differences.
• High primary hole closure rates: 96% for ILMP and 90% for ILMF (P=0.29).
• In pseudophakic eyes with successful closure, ILMP resulted in superior BCVA at 1 year (0.42 logMAR) compared to ILMF (0.71 logMAR).

Conclusions:

• Both ILMP and ILMF techniques achieve high FTMH closure rates.
• ILMP demonstrates superior visual outcomes in pseudophakic eyes compared to ILMF when FTMH is successfully closed.