Vitrectomy With Sequential Internal Limiting Membrane Peeling and Flap Formation in Closure of a Large, Traumatic Macular Hole

2020 ◽  
pp. 247412642093971
Author(s):  
Jeffrey A. Brown ◽  
Jonathan S. Chang
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Male Patient ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Flap Technique ◽  
Tissue Proliferation ◽  
Flap Procedure ◽  
Tangential Traction

Purpose: We report the use of sequential vitrectomy with internal limiting membrane (ILM) flaps in closure of a chronic, large, traumatic macular hole (MH) in a 32-year-old male patient. Methods: The patient underwent vitrectomy using a sequential ILM flap technique. Results: This sequential ILM flap technique resulted in complete closure of the MH and improvement in visual acuity. In this case, a second ILM flap procedure allowed for successful closure of a traumatic MH. Conclusions: This case suggests that the MH's closure may have been facilitated by both relief of tangential traction on the retina as well as glial tissue proliferation from presence of the ILM flap.

Autologous internal limiting membrane transplant for recurrent idiopathic macular holes

2020 ◽  
pp. 112067212090639 ◽  
Author(s):  
Tommaso Rossi ◽  
Carlandrea Trillo ◽  
Guido Ripandelli
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Outer Segment ◽  
Internal Limiting Membrane ◽  
Control Group ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose: To report a series of recurrent idiopathic macular holes treated by means of a free autologous internal limiting membrane flap and compare visual and anatomic results to a control group undergoing further internal limiting membrane peeling and novel gas tamponade. Methods: Retrospective surgical series of 15 consecutive patients receiving autologous internal limiting membrane flap compared to 14 patients operated on for internal limiting membrane peeling enlargement. Autologous internal limiting membrane flap was created after brilliant blue G staining, internal limiting membrane lifting, perfluorocarbon bubble injection and creation of a wide internal limiting membrane free flap translocated underneath perfluorocarbon liquid, to the macular hole bed. Both groups were tamponated with 20% SF6 and positioned face down for 4 h a day for 3 days. Results: Macular hole closed in 14/15 (93.3%) patients of the autologous internal limiting membrane group and 9/14 (64.2%) controls (p < 0.05). Visual acuity increased from 0.05 ± 0.03 to 0.23 ± 0.13 Snellen in the autologous internal limiting membrane group and from 0.05 ± 0.03 to 0.14 ± 0.10 Snellen of controls (p < 0.05 for both). Vision of the autologous internal limiting membrane group improved more than controls at 1 month (p = 0.043) and 3 months (p = 0.045). Inner segment/outer segment interruption at 3 months was smaller in the autologous internal limiting membrane group than controls, reducing from 1230 ± 288 µm at baseline to 611 ± 245 and 547 ± 204 µm at 3 months versus 1196 ± 362, 745 ± 222 and 705 ± 223 µm, respectively (p < 0.05). Conclusion: Autologous internal limiting membrane flap can effectively close recurrent idiopathic macular holes with a higher closure rate, smaller residual inner segment/outer segment line interruption and higher visual acuity at 3 months than previous standard of care.

scholarly journals Comparison of the Inverted Internal Limiting Membrane Flap Technique and the Internal Limiting Membrane Peeling for Macular Hole with Retinal Detachment

PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0165068 ◽  
Author(s):  
Takehiro Matsumura ◽  
Yoshihiro Takamura ◽  
Takeshi Tomomatsu ◽  
Shogo Arimura ◽  
Makoto Gozawa ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Flap Technique

Long-term functional and anatomical evolution in surgically closed macular holes with internal limiting membrane peeling

2019 ◽  
Vol 30 (5) ◽  
pp. 1112-1119
Author(s):  
Pauline Eymard ◽  
Yannick Le Mer
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Retinal Thickness ◽  
Internal Limiting Membrane ◽  
Macular Thickness ◽  
Full Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Full Thickness Macular Hole

Introduction: The aim of this study was to describe the long-term evolution of macular retinal thickness and visual acuity in patients who present surgically closed full-thickness macular hole, operated by vitrectomy with internal limiting membrane peeling. Methods: A retrospective observational study of patients operated for full-thickness macular hole with closure of the hole and at least 6 months of post-operative follow-up was performed. All patients had pars plana vitrectomy, peeling of the internal limiting membrane, gas filling and positioning. Comparison of the early post-operative (in the first 5 months) visual acuity and spectral-domain optical coherence tomography-measured macular thickness with late post-operative data (between 6 months and 6 years) was performed. Foveal retinal thickness and temporal and nasal retinal thickness between 1 and 3 mm from the centre were recorded. Results: In total, 35 eyes of 34 patients were included, with an early post-operative measure realized at a mean of 1.8 months and a late measure done at a mean of 25.5 months (7–73 months). Foveal thickness stayed unchanged (282 vs 288 µm), nasal parafoveal thickness remained increased compared to normal and stayed constant (345 vs 345 µm) and temporal parafoveal macular thickness was decreased (313 vs 308 µm) ( p = 0.028). Best-corrected visual acuity was improved by the surgery and the gain increased over time. Conclusion: Internal limiting membrane peeling improves anatomical success of full-thickness macular hole, but this procedure is not without long-term scalable consequences on macular thickness on the temporal quadrant (thinning) as on the nasal quadrant (thickening).

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