scholarly journals Displacement of the retina after idiopathic macular hole surgery with different internal limiting membrane peeling patterns

2021 ◽  
Vol 14 (9) ◽  
pp. 1408-1412
Author(s):  
Jin Liu ◽  
◽  
Xin-Hua Zheng ◽  
Yuan-Long Li ◽  
Jun-Long Huang ◽  
...  
Keyword(s):  
Macular Hole ◽  
Influencing Factor ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Significant Difference

AIM: To explore retinal displacement after surgical treatment for idiopathic macular hole (IMH) with different internal limiting membrane (ILM) peeling patterns. METHODS: Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups, N-T group (11 eyes) and T-N group (11 eyes). For patients in N-T group, ILM was peeled off from nasal to temporal retina. For patients in T-N group, ILM was peeled off from temporal to nasal retina. Preoperative, postoperative 1, 3, and 6mo, autofluorescence fundus images were collected for manual measurement of distances of fixed nasal (N), temporal (T), superior (S), and inferior (I) retinal points (bifurcation or crossing of retinal vessels) around the macula to the optic disc (OD). These were respectively defined as N-OD, T-OD, S-OD, and I-OD. The retinal displacement, macular hole closure rate, and best corrected visual acuity (BCVA) were compared between the two groups after surgery. RESULTS: At postoperative 1, 3, and 6mo, the macula slipped toward the OD, manifested by the decreased T-OD, N-OD, S-OD, and I-OD (P<0.05). No significant difference was found in the T-OD, N-OD, S-OD, and I-OD between N-T group and T-N group. IMH closure rate was 100% both in N-T group and T-N group. There was no significant difference in BCVA between two groups (P<0.05). CONCLUSION: The macula slips toward the OD after successful macular hole surgery. The two different ILM peeling pattern show similar visual outcome and retinal displacement, which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.

Internal retinal layer thickness and macular migration after internal limiting membrane peeling in macular hole surgery

2017 ◽  
Vol 28 (3) ◽  
pp. 311-316 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Sofia Mano ◽  
Diana M. Cristóvao ◽  
David C. Sousa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Layer Thickness ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Retinal Layer ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Retinal Layers ◽  
Sd Oct

Purpose: To provide a spectral-domain optical coherence tomography (SD-OCT)-based analysis of retinal layers thickness and nasal displacement of closed macular hole after internal limiting membrane peeling in macular hole surgery. Methods: In this nonrandomized prospective interventional study, 36 eyes of 32 patients were subjected to pars plana vitrectomy and 3.5 mm diameter internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH). Nasal and temporal internal retinal layer thickness were assessed with SD-OCT. Each scan included optic disc border so that distance between optic disc border and fovea were measured. Results: Thirty-six eyes had a successful surgery with macular hole closure. Total nasal retinal thickening (p<0.001) and total temporal retinal thinning (p<0.0001) were observed. Outer retinal layers increased thickness after surgery (nasal p<0.05 and temporal p<0.01). Middle part of inner retinal layers (mIRL) had nasal thickening (p<0.001) and temporal thinning (p<0.05). The mIRL was obtained by deducting ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness from overall thickness of the inner retinal layer. Papillofoveal distance was shorter after ILM peeling in macular hole surgery (3,651 ± 323 μm preoperatively and 3,361 ± 279 μm at 6 months; p<0.0001). Conclusions: Internal limiting membrane peel is associated with important alteration in inner retinal layer architecture, with thickening of mIRL and shortening of papillofoveal distance. These factors may contribute to recovery of disrupted foveal photoreceptor and vision improvement after IMH closure.

scholarly journals Retrospective study on outcome of macular hole surgery

2017 ◽  
Vol 8 (2) ◽  
pp. 139-143 ◽  
Author(s):  
S Singh ◽  
R Byanju ◽  
S Pradhan ◽  
G Lamichhane
Keyword(s):  
Macular Hole ◽  
Surgical Complication ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Gas Tamponade ◽  
Vitreous Cortex ◽  
Intraocular Gas ◽  
Hole Closure

Introduction: Macular hole is a common and treatable cause of central visual loss. Classic macular hole surgery consists of vitrectomy, posterior vitreous cortex removal and intraocular gas tamponade, but during the past decade focus has especially been on internal limiting membrane (ILM) peeling as adjuvant therapy for increasing closure rates. Objective: To determine and evaluate anatomical and visual outcome of macular hole surgery. Materials and methods: Retrospective analysis of all cases of macular hole surgery done by single surgeon between 2014 -2015. Results:16 eyes were analysed with follow up of 3 months. Macular hole closure after vitrectomy was 75% with visual improvement of two or more line in 62.5%.Post surgical complication included cataract 18.8%, Increased IOP 12.5% and retinal detachment 6.2%. Conclusion: Vitrectomy along with ILM peeling and Gas Tamponade with effective positioning improves in visual acuity and achieve hole closure in people with macular hole. 

scholarly journals Outcomes of Idiopathic Full-Thickness Macular Hole Surgery: Comparing Two Different ILM Peeling Sizes

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Alireza Khodabande ◽  
Alireza Mahmoudi ◽  
Hooshang Faghihi ◽  
Fatemeh Bazvand ◽  
Ebrahim Ebrahimi ◽  
...  
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Full Thickness Macular Hole ◽  
Significant Difference ◽  
Hole Index ◽  
The Impact ◽  
Anatomical Outcomes

Purpose. This study aimed to show the impact of different extents of internal limiting membrane (ILM) peeling on visual and anatomical outcomes following idiopathic full-thickness macular hole (FTMH) surgery. Methods. In this single-center prospective study, patients with idiopathic FTMH underwent standard pars plana vitrectomy with two different extents of ILM peeling: 2-disc diameters (DD) or 4 DD. The main outcome measures were the closure rate of the holes based on optical coherence tomography (OCT) findings at three months after surgery. Results. Forty eyes from 39 patients were enrolled in the study. After three months, anatomical closure was achieved in 78% and 76% eyes in 2 DD peel and 4 DD peel groups, respectively. From 29 eyes with macular hole index (MHI) ≤ 0.5, type 1 closure was achieved in 42% eyes receiving a 2 DD ILM peel, compared to 66% eyes receiving a 4 DD peel p=0.041. In comparison, this significant difference was not seen in the subgroup of MHI > 0.5 p=061. In the subgroup of subjects with baseline MHI ≤ 0.5, visual improvement was significantly more in eyes with 4 DD ILM peeling p=0.034, which was not seen in the MHI > 0.5 subgroup p=0.61. Conclusion. In patients with idiopathic full‐thickness macular hole (MHI ≤ 0.5), a larger ILM peel of 4 DD appears to yield better anatomical outcomes than a more limited 2 DD peel.

scholarly journals Choroidal and retinal displacements after vitrectomy with internal limiting membrane peeling in eyes with idiopathic macular hole

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kensuke Goto ◽  
Takeshi Iwase ◽  
Tomohiko Akahori ◽  
Kentaro Yamamoto ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Oct Angiography ◽  
Optical Coherence ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
En Face

AbstractIt has been reported that the macular region of the retina is displaced after vitrectomy with internal limiting membrane (ILM) peeling in eyes with macular hole (MH), but the displacements of the deeper layers of the eye, e.g. RPE and choroid are unclear following the surgery. We used optical coherence tomography (OCT) and OCT angiography (OCTA) to obtain 3 mm × 3 mm en face images before, and 2, 4, and 8 weeks following the vitrectomy with internal limiting membrane (ILM) peeling from 22 eyes of 22 patients with a MH. The OCT and OCTA images showed displacements of the fovea and choroidal intermediate vessels postoperatively. The degree of displacement of the choroid was significantly less than that of the retina (P < 0.001). The displacements of the choroidal bifurcations were significantly correlated to their preoperative distance from the optic disc (r = −0.467, P < 0.001) and they were significantly correlated with the retinal displacements (r = 0.535, P < 0.001). The retina was displaced inferiorly and centripetally, but these localized displacements were not observed in the choroid. In conclusion, clinicians need to be aware of these displacements when evaluating the subfoveal choroid following the surgery because the displacement is different between the retina and the choroid.

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