Claudio Iovino1, Giulia Caminiti1, Mario Miccoli2, Francesco Nasini3, Giamberto Casini3, Enrico Peiretti1. 1. 1 Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari - Italy. 2. 2 Department of Clinical and Experimental Medicine, University of Pisa, Pisa - Italy. 3. 3 Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa - Italy.
Abstract
PURPOSE: To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery. METHODS:Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated. RESULTS: All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022). CONCLUSIONS: The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.
RCT Entities:
PURPOSE: To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery. METHODS: Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated. RESULTS: All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022). CONCLUSIONS: The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.
Entities:
Keywords:
Inverted internal limiting membrane flap; Macular hole surgery; Pars plana vitrectomy; Subretinal aspiration