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A three-step approach versus the inverted internal limiting membrane flap technique in large full thickness macular
Dongwei Lai1,2,3, Siao Tang4, Chufeng Gu1,2,3
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, PR China.
Objective:
To evaluate the anatomical and functional outcomes of our novel surgery (a three-step approach) and the conventional inverted internal limiting membrane flap technique (IFT) in treating large full-thickness macular holes (FTMHs).
Methods:
This was a retrospective, consecutive, nonrandomized comparative study of patients who underwent either the novel surgery (n = 27, Group A) or IFT (n = 27, Group B). The main outcomes of MH closure rates and the best corrected visual acuity (BCVA) at 1-, 3-, and 6-month follow-up were compared between the two groups.
Results:
At 6 months postoperatively, MH closure was achieved in 24/27 patients in Group A and 22/27 patients in Group B (88.89% vs. 81.48%, P = 0.704) with U-shaped closure rates being significantly higher in Group A (P = 0.029). The average BCVA at month 6 was 0.69 ± 0.38 (LogMAR) in Group A and 0.91 ± 0.39 in Group B (P = 0.015) with the improvement in BCVA being significantly higher in Group A (0.50 ± 0.59 vs. 0.31 ± 0.59, P = 0.045). The recovery rates of ELM were significantly higher in Group A (P = 0.026).
Conclusions:
Our three-step approach greatly improves anatomical and functional outcomes compared with IFT. This novel surgery has a dominant advantage in earlier and higher ultimate closure rate, U-type closure rate, and ELM recovery rate, and more importantly, better recovery of BCVA.
