Efficacy of Air Tamponade Treatment of Idiopathic Macular Holes of Different Diameters and of Follow-up Intravitreal Air Tamponade for Persistent Holes

Retina ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jiwei Tao ◽  
Huan Chen ◽  
Yiqi Chen ◽  
Jiangxin Yu ◽  
Jiawen Xu ◽  
...  
Keyword(s):  
Macular Holes ◽  
Air Tamponade ◽  
Idiopathic Macular Holes ◽  
Different Diameters

scholarly journals Comparison of Anatomical and Visual Outcomes between Idiopathic and Myopic Macular Holes Using the Internal Limiting Membrane or Inverted Internal Limiting Membrane Flap Technique

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Federico Peralta Iturburu ◽  
Claudia Garcia-Arumi ◽  
Maria Bové Alvarez ◽  
Jose Garcia-Arumi
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Small Sample Size ◽  
Internal Limiting Membrane ◽  
Small Sample ◽  
Ilm Peeling ◽  
Visual Outcomes ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose. To compare the results of vitrectomy with those of internal limiting membrane (ILM) peeling or inverted ILM flap for treating myopic or idiopathic macular hole. Methods. Thirty-nine eyes of 39 patients undergoing vitrectomy with ILM peeling for macular hole (25 idiopathic and 14 myopic) and 27 eyes of 27 patients undergoing vitrectomy with inverted ILM flap (15 idiopathic and 12 myopic) were included. Outcome measures were macular hole closure by optical coherence tomography and visual acuity at 6 months. Results. Closure was achieved in 25 (100%) idiopathic and 12 (86%) myopic macular holes in the ILM peeling group and in 14 (93%) idiopathic and 11 (91.77%) macular holes in the inverted ILM flap group. There were no statistically significant differences in restoration of the external limiting membrane and ellipsoid zone between the groups. Median best-corrected visual acuity (logarithm of minimal angle of resolution) at the end of follow-up was 0.22 (20/32 Snellen) in idiopathic and 0.4 (20/50) in myopic (P=0.042) patients in the ILM peeling group and 0.4 (20/50) in idiopathic and 0.4 (20/50) in myopic (P=0.652) patients in the inverted ILM flap group. Conclusion. Both techniques were associated with high closure rates in myopic and idiopathic macular holes, with somewhat better visual outcomes in idiopathic cases. The small sample size may have provided insufficient power to support the superiority of one technique over the other in the two groups.

scholarly journals Effect of internal limiting membrane peeling on normal retinal function evaluated by microperimetry-3

2020 ◽  
Author(s):  
Yue Qi ◽  
Zengyi Wang ◽  
Shi-Ming Li ◽  
Qisheng You ◽  
Xida Liang ◽  
...  
Keyword(s):  
Internal Limiting Membrane ◽  
Retinal Function ◽  
Fundus Photography ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Pars Plana ◽  
Air Tamponade ◽  
23 Gauge

Abstract Background To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3). Methods This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function. Results We incuded 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06±0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53±0.30, P<0.01) and 4 months (0.31±0.24, P<0.01), respectively. Mean retinal sensitivity (MRS, dB) of the retina surrounding macular hole was 23.46±3.01 dB at baseline, and significantly increased at 1 month (26.25±2.31 dB, u=-4.88, P<0.01) and 4 months(27.14±2.45 dB, t=-6.29, P<0.01). Patients with increased MRS are significantly younger than those with deceased MRS (59.72±3.22 years vs. 65.60±8.19 years, P<0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than in superior and temporal retina at 1 and 4 months (P<0.05). Conclusion ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.

scholarly journals The effect of internal limiting membrane peeling to normal retinal function evaluated by microperimetry-3

2019 ◽  
Author(s):  
Yue Qi ◽  
Zengyi Wang ◽  
Qisheng You ◽  
Xida Liang ◽  
Yanping Yu ◽  
...  
Keyword(s):  
Internal Limiting Membrane ◽  
Retinal Function ◽  
Fundus Photography ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Pars Plana ◽  
Air Tamponade ◽  
23 Gauge

Abstract Background To evaluate the effect of internal limiting membrane (ILM) peeling to the function of retina surrounding macular holes (MH) by microperimetry-3(MP-3). Methods This is a prospective, cohort study which included 44 eyes of 44 patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were used 1 week before and 1, 4 months after operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function. Results All eyes had achieved an anatomical success at the last follow-up. BCVA (logMAR) significantly improved both in 1 and 4 months after surgery (1.06±0.40 versus 0.53±0.30 and 0.31±0.24, P<0.01). The mean retinal sensitivity (MRS) (in dB) of the retina surrounding macular hole significantly increased 1 and 4 months after ILM peeling: pre-operative 23.46±3.01 dB versus post-operative 26.25±2.31 dB (u=-4.88, P<0.01) in 1 month and 27.14±2.45 dB (t=-6.29, P<0.01) in 4 months. Patients with increased MRS are significantly younger than patients with deceased MRS (59.72±3.22 years versus 65.60±8.19 years, P<0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than that in superior and temporal retina both in 1 and 4 months (P<0.05). Conclusion ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.

scholarly journals Effect of internal limiting membrane peeling on normal retinal function evaluated by microperimetry-3

2020 ◽  
Author(s):  
Yue Qi ◽  
Zengyi Wang ◽  
Shi-Ming Li ◽  
Qisheng You ◽  
Xida Liang ◽  
...  
Keyword(s):  
Internal Limiting Membrane ◽  
Retinal Function ◽  
Fundus Photography ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Pars Plana ◽  
Air Tamponade ◽  
23 Gauge

Abstract Introduction To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3). Materials and Methods This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function. Results We included 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06±0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53±0.30, P<0.01) and 4 months (0.31±0.24, P<0.01), respectively. Mean retinal sensitivity (MRS, dB) of the retina surrounding macular hole was 23.46±3.01 dB at baseline, and significantly increased at 1 month (26.25±2.31 dB, u=-4.88, P<0.01) and 4 months(27.14±2.45 dB, t=-6.29, P<0.01). Patients with increased MRS are significantly younger than those with deceased MRS (59.72±3.22 years vs. 65.60±8.19 years, P<0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than in superior and temporal retina at 1 and 4 months (P<0.05). Conclusion ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.

scholarly journals A short term anatomical and visual outcomes of large idiopathic macular holes surgery following inverted internal limiting membrane flap technique

2019 ◽  
Vol 11 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Kiran Shakya ◽  
Ram Prasad Pokharel ◽  
Om Krishna Malla
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Hole Filling ◽  
Flap Technique ◽  
Macular Holes ◽  
Snellen Chart ◽  
Pars Plana ◽  
Idiopathic Macular Holes ◽  
The Mean

Introduction: Large macular holes are not uncommon among Nepalese women population causing severe visual problem. Objective: To evaluate the technique of inverted internal limiting membrane (ILM) flaps for the repairment of large macular holes. Methods: All 10 macular holes (diameter > 400 μm) were treated with pars planavitrectomy with inverted ILM flap technique. The procedure for macular hole surgerywas pars plana vitrectomy, posterior vitreous removal, internal limiting membrane(ILM) peeling with brilliant blue assisted, inverting ILM flap into macular hole, filling of the vitreous cavity with a gas bubble(C3 F8) and post-operative face-down positioning for 1 week. SD OCT images were taken preoperative and postoperative 1 month and 3 months follow up to assess the anatomical outcome of surgery and best corrected visual acuity (BCVA) was used to evaluate the functional outcome during each visit. The BCVA was recorded using the Snellen chart and was converted to the logarithm of the minimum angle of resolution (LogMAR) equivalents. Results: All 10 eyes had complete anatomical closure. The mean age of patients was 64.3 ± 7.53 years. The mean macular hole base diameter was 1039.4 μm (663-1526μm). Mean BVCA pre-operatively was 1.29 log MAR ±SD 0.25. Post-operatively, mean BCVA was 0.925 log MAR ±SD 0.143 (p= 0.002). There were no intra operative or post-operative complications. All the patients were followed up for a period of 3months. Conclusions: Inverted ILM flaps is effective for closure of the large macular hole and restoration of functional vision.

scholarly journals Hole Diameter ratio (HDR) for prediction of anatomical outcomes in stage III and IV idiopathic macular holes

2020 ◽  
Author(s):  
Yue Qi ◽  
Yanping Yu ◽  
Zengyi Wang ◽  
Jing Wang ◽  
Wu Liu
Keyword(s):  
Predictive Factor ◽  
Diameter Ratio ◽  
Hole Diameter ◽  
Stage Iii ◽  
Maximum Diameter ◽  
Ilm Peeling ◽  
Macular Holes ◽  
Air Tamponade ◽  
Idiopathic Macular Holes ◽  
Anatomical Outcome

Abstract Summary: In this study, we reviewed 101 eyes with stage III or IV IMHs treated by PPV combined with ILM peeling and room air tamponade, took the ratio of minimum diameter to maximum diameter (hole diameter ratio, HDR) as the predictive factor and found HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome.Purpose: To identify hole diameter ratio (HDR) as the predictive factor for unclosed stage III and IV idiopathic macular holes (IMHs) by the use of preoperative optical coherence tomography (OCT).Methods: 101 eyes with stage III or IV IMH were included in this retrospective case series study.
All cases were treated with vitrectomy combined with ILM peeling and room air tamponade. The MH minimum and maximum diameter, the ratio of the minimum to the maximum diameter (which defined as HDR) were performed. Results: 81 eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The minimal diameter of IMHs (703.6±116.1um VS 597.6±120.1um, P<0.01) and HDR (0.6±0.1 VS 0.5±0.1, P=0.01) were both significantly different between two groups. The cutoff value of the receiver operating characteristic curve was 0.6. The IMH with the HDR that less than 0.6 were defined as “A” type IMH and the others were defined as “H” type IMH. The closure rate of two type IMHs were 90.2% and 65.0% respectively. It had significant differences. (P=0.002) Conclusions: HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome in stage III and IV IMHs after vitrectomy combined with LM peeling and room air tamponade.

scholarly journals COMPARATIVE RESULTS OF SURGICAL TREATMENT OF LARGE IDIOPATHIC MACULAR HOLES

2016 ◽  
Vol 1 (6) ◽  
pp. 19-23
Author(s):  
Шпак ◽  
Aleksandr Shpak ◽  
Шкворченко ◽  
Dmitriy Shkvorchenko ◽  
Шилов ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Limiting Membrane ◽  
New Technique ◽  
Minimum Diameter ◽  
Mean Values ◽  
Vacuum Aspiration ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Comparative Results

The goal is to evaluate the effectiveness of the developed technique of the gradual forming of the internal limiting membrane (IML) fragment in the treatment of large macular holes (MH) in comparison with the standard methodol-ogy (using classical maculorhexis and rapprochement of MH edges by using of vacuum aspiration). Materials and methods: we observed 137patients (103women, 34men) aged from 54 to 78years with large MH (over 400μm). Duration of MH ranged from 3 to 60months. All the patients were divided into groups: 1 (new methodology) and 2 (standard method), and sub-groups: 1a and 2a – patients with MH with a minimum diameter 400–650μm; 1b and 2b – patients with MH with a minimum diameter more than 650μm. The new technique is performed in several stages, during which several series of ILM “petals” removal are made, leaving an intact area on the MH edge. The last ILM “petal” or fragment is inverted and placed on the MH. Results: In subgroup 1a, there was a statistically significant increase in best corrected visual acuity (BCVA) during all follow-up with the most pronounced growth in the first 6 months (from 0.15±0.06 to 0.55±0.14) (p&#60;0.05). In subgroup 1b a statistically significant increase in mean values of BCVA was also observed especially during first 6month (from 0.13±0.06 to 0.36±0.12) (p&#60;0.05). In group2 (a, b) BCVA was significantly lower (p&#60;0.05). Conclusion: the new technique allows to reach higher functional-anatomical results in surgical treatment of MH.

scholarly journals Pre- and Post-operative Differences Between Genders in Idiopathic Macular Holes

2020 ◽  
Author(s):  
Jing Wang ◽  
Yanping Yu ◽  
Xida Liang ◽  
Zengyi Wang ◽  
Biying Qi ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Age Of Onset ◽  
Closure Rate ◽  
Recovery Duration ◽  
Macular Holes ◽  
Younger Age ◽  
Stage 4 ◽  
Before And After ◽  
Idiopathic Macular Holes

Abstract Background: To compare idiopathic macular holes (IMHs) between male and female before and after surgery.Methods: Patients with IMHs of stage 3 and stage 4 who underwent 23-guage vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriated statistical methods. Results: A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P=0.045), larger horizontal MLD (P=0.009), but similar surgical outcomes except for a relatively longer recovery duration (P=0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P=0.023), larger MLD (P=0.003), and smaller height of the hole (P=0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders.Conclusions: Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes.

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