Inverted Internal Limiting Membrane Flap plus Fovea-Sparing Peeling and Repositioning: A Novel Approach for Myopic...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Macular Diseases

Background:

• Myopic traction maculopathy (MTM) presents challenges in surgical management, particularly concerning the risk of postoperative full-thickness macular hole (FTMH) formation.
• The internal limiting membrane (ILM) plays a crucial role in MTM pathogenesis and surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel Inverted ILM flap Procedure (IPS) for MTM.
• To assess the IPS technique's ability to mitigate the risk of FTMH in high-risk MTM patients.

Main Methods:

• Retrospective, consecutive interventional case series of eight MTM patients with lamellar macular hole and foveal detachment.
• All patients underwent vitrectomy with the IPS technique, including an inverted ILM flap, fovea-sparing peeling, repositioning, and sub-perfluoro-n-octane assisted ophthalmic viscoelastic device injection.
• Minimum follow-up of 6 months.

Main Results:

• Mean visual acuity improved significantly (0.54 to 0.23 logMAR).
• Mean central foveal thickness reduced substantially (571.6 µm to 279.5 µm).
• No FTMH developed postoperatively; retinoschisis resolved in 62.5% and foveal detachment reversed in 83.3% of cases.

Conclusions:

• The IPS procedure effectively relieves traction and restores ILM integrity in MTM.
• This technique minimizes surgical trauma and protects the fovea, reducing FTMH risk and improving functional and morphological outcomes.