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Macular Hole Closure by Internal Limiting Membrane Flap without Gas Tamponade versus Conventional Surgery: A
Simon K H Szeto1, Julia T W Lam2, Amy H Y Yu2
1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, Hong Kong SAR, China; Pao So Kok Macular Disease Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chines University of Hong Kong, Hong Kong SAR, China.
The novel internal limiting membrane (ILM) flap technique without gas tamponade achieves high macular hole (MH) closure rates comparable to conventional surgery. This method offers improved early vision and reduced foveal gliosis, showing promise for MH repair.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Hole Repair
Background:
- Macular holes (MHs) are a significant cause of vision loss.
- Conventional MH repair often involves gas tamponade, which can be associated with complications.
- The internal limiting membrane (ILM) flap technique is a newer approach to MH repair.
Purpose of the Study:
- To compare the effectiveness and safety of the ILM flap with no gas tamponade versus conventional surgery for MH repair.
- To evaluate visual acuity, MH closure rates, and postoperative OCT features.
Main Methods:
- Retrospective comparative study of 93 patients with full-thickness MH.
- Patients underwent either conventional surgery or ILM flap with no gas tamponade.
- Data collected included demographics, surgical details, and OCT features; primary outcome was MH closure at 3 months.
Main Results:
- MH closure rates were high and comparable in both groups (94.1% vs. 95.2%).
- The no gas tamponade group showed significantly better visual acuity at postoperative weeks 1 and 1 month.
- The no gas tamponade group had a lower rate of foveal gliosis (4.9% vs. 20.0%).
Conclusions:
- The ILM flap with no gas tamponade technique is a feasible and effective method for MH repair.
- This novel technique achieves high closure rates comparable to conventional surgery.
- It offers advantages of improved early visual recovery and reduced foveal gliosis.
