Joana Pires1, Jeroni Nadal2, Nuno Lourenço Gomes3. 1. Department of Ophthalmology, Centro Hospitalar do Baixo Vouga, Porto, Portugal. 2. Department of Ophthalmology, Centro de Oftalmología Barraquer, Barcelona, Spain. 3. Department of Ophthalmology, Hospital de Braga, Braga, Portugal.
Abstract
BACKGROUND/AIMS: Closure is more difficult to achieve in macular holes that remain open following a previous unsuccessful pars plana vitrectomy (PPV). We present our results with the internal limiting membrane (ILM) translocation technique that is used to optimise outcomes in refractory macular holes. METHODS: A prospective, interventional, case series was conducted. 12 eyes of 12 consecutive patients with incomplete sealing of the macular hole (open and type 2 closure) after a previous PPV with ILM peeling were included. Measured baseline parameters included best-corrected visual acuity (BCVA) and macular hole smallest diameter, base diameter and height. Surgeries were performed by harvesting a fragment of the ILM near the vascular arcades and subsequently placing it inside the hole. Postoperative measured outcomes included macular hole status, foveal contour, outer retina integrity, BCVA and surgery-related complications. RESULTS: Anatomic closure occurred in 11 of 12 eyes (91%). This technique elicited a statistically significant improvement in BCVA (p=0.008). Mean BCVA was 20/400 at study baseline and 20/160 at final follow-up. However, less than 16.7% of cases had a final BCVA of ≥20/63. CONCLUSION: The ILM translocation technique seems to facilitate persistent idiopathic macular hole closure, where primary surgery with PPV and ILM peeling failed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND/AIMS: Closure is more difficult to achieve in macular holes that remain open following a previous unsuccessful pars plana vitrectomy (PPV). We present our results with the internal limiting membrane (ILM) translocation technique that is used to optimise outcomes in refractory macular holes. METHODS: A prospective, interventional, case series was conducted. 12 eyes of 12 consecutive patients with incomplete sealing of the macular hole (open and type 2 closure) after a previous PPV with ILM peeling were included. Measured baseline parameters included best-corrected visual acuity (BCVA) and macular hole smallest diameter, base diameter and height. Surgeries were performed by harvesting a fragment of the ILM near the vascular arcades and subsequently placing it inside the hole. Postoperative measured outcomes included macular hole status, foveal contour, outer retina integrity, BCVA and surgery-related complications. RESULTS: Anatomic closure occurred in 11 of 12 eyes (91%). This technique elicited a statistically significant improvement in BCVA (p=0.008). Mean BCVA was 20/400 at study baseline and 20/160 at final follow-up. However, less than 16.7% of cases had a final BCVA of ≥20/63. CONCLUSION: The ILM translocation technique seems to facilitate persistent idiopathic macular hole closure, where primary surgery with PPV and ILM peeling failed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Umberto Lorenzi; Joel Mehech; Tommaso Caporossi; Mario R Romano; Rocco De Fazio; Eric Parrat; Frédéric Matonti; Paolo Mora Journal: Graefes Arch Clin Exp Ophthalmol Date: 2022-07-06 Impact factor: 3.117
Authors: Peter Szurman; Philip Wakili; Boris V Stanzel; Rudolf Siegel; Karl T Boden; Annekatrin Rickmann Journal: Graefes Arch Clin Exp Ophthalmol Date: 2021-06-02 Impact factor: 3.117