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 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.

Method of surgical treatment of small and medium diameter macular holes with the foveal-sparing internal limiting membrane peeling

2021 ◽  
pp. 213-216
Author(s):  
A.A. Shpak ◽  
◽  
A.I. Kolesnik ◽  
F.A. Avakyan ◽  
V.A. Pismenskaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Developed Countries ◽  
Clear Understanding ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Air Tamponade ◽  
Medium Diameter

Introduction and purpose. Idiopathic macular hole (IMH) is an urgent medical and social problem of the population of developed countries. It is known that microinvasive 3-port vitrectomy with gas-air tamponade is a generally accepted method of surgical treatment of IMH. There is still no clear understanding of the reasons for incomplete functional success in this category of patients, despite the anatomical success.Thus, there is a need to develop and implement in clinical practice a modification of the ILM peeling technique for the treatment of small and medium-diameter of IMH, which would not be inferior in anatomical effectiveness to existing methods and would be accompanied by a less damaging effect on the structures of the retina. Material and methods. The study included 10 patients with a diagnosis of IMH, who underwent a 3-port microinvasive 25G vitrectomy with the preservation of foveal ILM. Results. The analysis of the clinical and functional results of surgical treatment of IMH with the foveal fragment left revealed the complete closure of the macular tear, the absence of gross defects of the ellipsoid zone, an increase in the values of the average visual acuity and microperimetry from the 1st month of dynamic observation. Conclusion. The proposed low-traumatic method of fovea - sparing ILM peeling provides stable anatomical and functional result, the restoration of both morphological and functional parameters, and minimizes the mechanical impact on the retina in the fovea. Key words: macular rupture, internal limiting membrane, fovea-sparing ILM peeling.

scholarly journals Long-Term Outcome of Vitrectomy with Suitable Internal Limiting Membrane Peeling and Air Tamponade for Highly Myopic Foveoschisis-Associated Lamellar Macular Hole

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jia-lin Wang ◽  
Yan-ling Wang
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Lamellar Macular Hole ◽  
Ilm Peeling ◽  
Long Term Outcome ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Myopic Foveoschisis ◽  
Air Tamponade

Purpose. To investigate the outcome of pars plana vitrectomy (PPV) with suitable internal limiting membrane peeling (ILM) and air tamponade for patients with highly myopic foveoschisis-associated lamellar macular hole (MH). Methods. This retrospective interventional case series included 11 patients with highly myopic foveoschisis-associated lamellar MH who underwent PPV and indocyanine green-aided ILM peeling up to the temporal vascular arcades. Following air tamponade after surgery, all patients were instructed to maintain a face-down position. The patients were followed up for over 1 year and evaluated for MH closure and the best-corrected visual acuity before and after surgery. Results. The mean ± standard deviation values of patient age, axial length, and follow-up duration were 67.82 ± 6.54 years, 29.21 ± 1.95 mm, and 24.27 ± 8.11 months, respectively. After surgery, the lamellar MH closed in all eyes, and 10 eyes showed vision improvement at the 1-month, 3-month, and final follow-up evaluations. One patient showed decreased vision at 2 years after surgery, with patchy chorioretinal atrophy in the macular region. Myopic foveoschisis showed resolution in three eyes and alleviation in eight. Ten patients underwent cataract surgery during PPV. Conclusion. Extension of ILM peeling up to the temporal vascular arcades and air tamponade after PPV may improve the visual function and rate of MH closure for patients with highly myopic foveoschisis-associated lamellar MH.

scholarly journals The outcome of vitrectomy with internal limiting membrane peeling for chronic macular hole at Biratnagar eye hospital: A tertiary eye care center in Nepal

2016 ◽  
Vol 7 (6) ◽  
pp. 43-46
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Pratap Karki ◽  
Abhishek Anand
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Chronic Stage ◽  
Visual Improvement ◽  
Macular Holes ◽  
Pars Plana ◽  
Hole Closure

Background:  A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea, thereby affecting central visual acuity. Pars plana vitrectomy and gas tamponade is a recognised modality of treatment for macular hole.Larger holes are more likely to remain open after repair and late reopening after an initially closed macular hole is seen in macular holes larger than 400 μm.Aims and Objective: To evaluate the anatomical and functional outcome of pars plana vitrectomy with internal limiting membrane peeling for chronic stage 3 macular hole.Materials and Methods: Records of 15 patients with stage 3 chronic macular holes operated from 1st January 2013 to 30th June 2013 and completed 1 year of follow up were retrospectively evaluated and included in the study. Preoperative best distance corrected visual acuity (BCVA), preoperative macular hole size, final BCVA and macular hole status at 1 year follow up were recorded. Macular hole closure and visual improvement was calculated. Correlation of macular hole closure and visual improvement with various macular hole parameter was estimated.Results: Eleven (73.3%) macular holes closed at 1 year follow-up. Mean BCVA improved from 1.2 ± 0.27 to 0.89 ± 0.36 logarithm of minimum angle of resolution at 1 year (p<0.001). Visual improvement was seen in only eight (53.3%) eyes. Both macular hole closure and visual improvement showed no correlation with minimum linear diameter, base diameter and hole height.Conclusion: Chronic stage 3 macular hole can be closed successfully in majority of patients with fairly good visual improvement. Macular hole parameters of stage 3 holes may not have any correlation with the anatomical and visual outcome.Asian Journal of Medical Sciences Vol.7(6) 2016 43-46

scholarly journals Comparative efficacy evaluation of inverted internal limiting membrane flap technique and internal limiting membrane peeling in large macular holes: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu Shen ◽  
Xiaoqin Lin ◽  
Luyi Zhang ◽  
Miaoqin Wu
Keyword(s):  
Sensitivity Analysis ◽  
Meta Analysis ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Visual Outcomes ◽  
Flap Technique ◽  
Macular Holes

Abstract Background The purpose of this study was to compare the anatomical and visual outcomes of inverted internal limiting membrane (ILM) flap technique and internal limiting membrane peeling in large macular holes (MH). Methods Related studies were reviewed by searching electronic databases of Pubmed, Embase, Cochrane Library. We searched for articles that compared inverted ILM flap technique with ILM peeling for large MH (> 400 μm). Double-arm meta-analysis was performed for the primary end point that was the rate of MH closure, and the secondary end point was postoperative visual acuity (VA). Heterogeneity, publication bias, sensitivity analysis and subgroup analysis were conducted to guarantee the statistical power. Results This review included eight studies involving 593 eyes, 4 randomized control trials and 4 retrospective studies. After sensitivity analysis for eliminating the heterogeneity of primary outcome, the pooled data showed the rate of MH closure with inverted ILM flap technique group was statistically significantly higher than ILM peeling group (odds ratio (OR) = 3.95, 95% confidence interval (CI) = 1.89 to 8.27; P = 0.0003). At the follow-up duration of 3 months, postoperative VA was significantly better in the group of inverted ILM flap than ILM peeling (mean difference (MD) = − 0.16, 95% CI = − 0.23 to 0.09; P < 0.00001). However, there was no difference in visual outcomes between the two groups of different surgical treatments at relatively long-term follow-up over 6 months (MD = 0.01, 95% CI = − 0.12 to 0.15; P = 0.86). Conclusion Vitrectomy with inverted ILM flap technique had a better anatomical outcome than ILM peeling. Flap technique also had a signifcant visual gain in the short term, but the limitations in visual recovery at a longer follow-up was found.

scholarly journals A Modified Surgical Technique of Fovea-Sparing Internal Limiting Membrane Peeling: Continuous Arc-Shaped Foldback Peeling

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zheng-Gao Xie ◽  
Qing-Yi He ◽  
Jun Zhu ◽  
Wei Du ◽  
Jun Tong ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Internal Limiting Membrane ◽  
Outer Side ◽  
Ilm Peeling ◽  
Narrow Strip ◽  
Internal Limiting Membrane Peeling ◽  
Minimum Angle ◽  
Temporal Side ◽  
23 Gauge

Purpose. To investigate the efficacy of management of high myopic foveoschisis (MF) with a modified surgical technique of arc-shaped foldback fovea-sparing internal limiting membrane (ILM) peeling. Methods. A 23-gauge vitrectomy was performed in five patients with high MF. A long strip of ILM was peeled at the temporal side of the central fovea. Next, an ILM forceps was used to grasp the outer side of the ILM flap, and it was moved forward slowly from the outside to the paracentral fovea, followed by folding ILM back in an arc-shaped manner and then removing it. The above operations were repeated, and all ILM flaps were removed from the outside to paracentral fovea until a narrow strip of ILM remained. Finally, the narrow strip of ILM was excised using a vitreous cutter. Results. At the patients’ last visits, the foveoschisis almost disappeared completely and the fovea reattached. The central macular thickness statistically decreased from 399.0 ± 96.33 μm preoperatively to 164.60 ± 34.20 μm postoperatively (t = 4.289; P=0.013). The preoperative mean logarithm of the minimum angle of resolution best-corrected visual acuity (1.64 ± 0.65) significantly improved to 0.72 ± 0.18 postoperatively (t = 3.265, P=0.031). The average follow-up time was 11.80 ± 3.35 months (range; 8–16 months). Conclusion. The arc-shaped foldback fovea-sparing ILM peeling technique for high MF is safe and effective.

scholarly journals Eccentric Macular Hole after Pars Plana Vitrectomy for Idiopathic Macular Hole: A Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Irini Chatziralli ◽  
George Theodossiadis ◽  
Maria Douvali ◽  
Alexandros A. Rouvas ◽  
Panagiotis Theodossiadis
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Pars Plana ◽  
23 Gauge ◽  
Retinal Hole ◽  
The Right

Introduction: Postoperative eccentric macular hole (MH) formation is an uncommon complication after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for epiretinal membrane or MH treatment. Herein, we present a case of eccentric MH formation after PPV with ILM peeling for MH. Case Description: A 72-year-old female patient underwent 23-gauge PPV with ILM peeling for idiopathic MH in her right eye. The visual acuity was 6/24 in the right eye. One week postoperatively the retina was attached and the MH seemed to be closed, while visual acuity was 6/12. One month after PPV, there was a single eccentric retinal hole below the macula, which was detected at the fundoscopy and was confirmed by OCT. The visual acuity was 6/9 and the patient referred no symptoms. No further intervention was attempted, and at the 6-month follow-up the visual acuity and the size of the eccentric MH remained stable. Conclusions: Eccentric MHs can develop after PPV and are usually managed conservatively by observation.

scholarly journals Comparative efficacy evaluation of inverted internal limiting membrane flap technique and internal limiting membrane peeling in large macular holes: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yu Shen ◽  
Xiaoqin Lin ◽  
Luyi Zhang ◽  
Miaoqin Wu
Keyword(s):  
Sensitivity Analysis ◽  
Meta Analysis ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Visual Outcomes ◽  
Flap Technique ◽  
Macular Holes

Abstract Background: The purpose of this study was to compare the anatomical and visual outcomes of inverted internal limiting membrane (ILM) flap technique and internal limiting membrane peeling in large macular holes (MH). Methods: Related studies were reviewed by searching electronic databases of Pubmed, Embase, Cochrane Library. We searched for articles that compared inverted ILM flap technique with ILM peeling for large MH (> 400 μm). Double-arm meta-analysis was performed for the primary end point that was the rate of MH closure, and the secondary end point was postoperative visual acuity (VA). Heterogeneity, publication bias, sensitivity analysis and subgroup analysis were conducted to guarantee the statistical power. Results: This review included eight studies involving 593 eyes, 4 randomized control trials and 4 retrospective studies. After sensitivity analysis for eliminating the heterogeneity of primary outcome, the pooled data showed the rate of MH closure with inverted ILM flap technique group was statistically significantly higher than ILM peeling group (odds ratio (OR) = 3.95, 95% confidence interval (CI) = 1.89 to 8.27; P = 0.0003). At the follow-up duration of 3 months, postoperative VA was significantly better in the group of inverted ILM flap than ILM peeling (mean difference (MD) = -0.16, 95% CI = -0.23 to 0.09; P ＜ 0.00001). However, there was no difference in visual outcomes between the two groups of different surgical treatments at relatively long-term follow-up over 6 months (MD = 0.01, 95% CI = -0.12 to 0.15; P = 0.86). Conclusion: Vitrectomy with inverted ILM flap technique had a better anatomical outcome than ILM peeling. Flap technique also had a signifcant visual gain in the short term, but the limitations in visual recovery at a longer follow-up was found. Keywords: Inverted internal limiting membrane flap technique, Internal limiting membrane peeling, Large macular hole, Meta-analysis

Anatomical and Functional Outcomes of Relaxing Parafoveal Nasal Retinotomy for Refractory Macular Hole Repair

2021 ◽  
pp. 247412642098714
Author(s):  
Michael S. Tsipursky ◽  
Matthew Byun ◽  
Rama D. Jager ◽  
Veeral S. Sheth
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Postoperative Outcomes ◽  
Aperture Diameter ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Pars Plana

Purpose: This work aimed to assess postoperative outcomes associated with relaxing parafoveal nasal retinotomy for refractory macular hole repair. Methods: This was a retrospective interventional study of patients with persistent or recurrent macular holes following 1 or more standard repair procedures with pars plana vitrectomy and internal limiting membrane peeling. Patients received an additional pars plana vitrectomy and relaxing parafoveal nasal retinotomy, followed by fluid-air and air-gas exchange. Key postoperative outcomes included the achievement of macular hole closure and changes in visual acuity from baseline. Results: Thirteen patients with refractory macular holes were included, with a median age of 65 years (range, 49-90 years). The aperture diameter of the 13 macular holes ranged from 180 to 799 µm (median, 538 µm). Vitrectomy and relaxing parafoveal nasal retinotomy were performed in all 13 eyes, and after a median follow-up of 12 months (range, 3-34 months), anatomical closure was achieved in 12 of 13 eyes (92.3%). Overall, visual acuity (mean ± SE) improved significantly from 1.20 ± 0.15 logMAR (approximate Snellen equivalent, 20/320) at baseline to 0.84 ± 0.11 logMAR (Snellen, ∼ 20/125) during postoperative follow-up ( P < .05). Central and paracentral scotomas were observed in 8 of 11 eyes with postoperative Humphrey visual field 10-2 and/or 24-2 data available. Conclusions: Relaxing parafoveal nasal retinotomy may be an effective method to promote anatomical closure and improve vision outcomes in patients with recalcitrant macular holes.

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