Functional and Anatomical Micro-Structural Recovery of Idiopathic Macular Holes Following the Inverted Internal...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Macular Hole Treatment

Background:

• Idiopathic macular holes (MHs) are commonly treated with pars plana vitrectomy and internal limiting membrane (ILM) peeling.
• The inverted ILM flap (ILMF) technique is a newer approach for MHs, but long-term outcomes require further investigation.

Purpose of the Study:

• To evaluate the long-term functional and anatomical outcomes of the ILMF technique in patients with idiopathic MHs.
• To assess the sustained recovery of visual acuity and macular microstructure after ILMF surgery.

Main Methods:

• A study of 71 consecutive eyes with idiopathic MHs undergoing vitrectomy with the inverted ILMF technique.
• Follow-up exceeding 12 months, including visual acuity measurements and optic coherence tomography (OCT) for macular anatomy assessment.

Main Results:

• Significant improvement in visual acuity from 1.02 logMAR preoperatively to 0.47 logMAR postoperatively (p < 0.001).
• High primary (94.37%) and secondary (97.18%) MH closure rates were observed.
• Recovery of external limiting membrane (ELM), inner/outer segment (IS/OS) junction, and foveal contour showed sustained improvement up to three years.

Conclusions:

• The ILMF approach yields meaningful long-term visual and microstructural recovery in idiopathic MHs.
• Favorable functional outcomes and intact postoperative microstructure are sustained for up to three years.