San-Ni Chen1,2. 1. Department of Ophthalmology, Changhua Christian Hospital, No. 135, Nanhsio St, Changhua City, 500, Taiwan. 108562@cch.org.tw. 2. College of Medicine, Chung-Shan Medical University, Taichung City, Taiwan. 108562@cch.org.tw.
Abstract
PURPOSE: To describe the technique and surgical outcomes of a modified large semicircular inverted internal limiting membrane (ILM) flap in the management of macular holes (MHs) in patients with high myopia. METHODS: We performed this retrospective study on consecutive patients with MH and high myopia (axial length ≥ 28 mm),who received vitrectomy, a large semicircular ILM flap 4 discs in diameter to cover the MH, incomplete air-fluid exchange, and SF6 gas tamponade. All of the patients maintained an upright position for 2 h postoperatively, followed by either a face-down or upright position for 1 week. Post-operative visual acuity was measured, and MH status was assessed using spectral-domain optical coherence tomography. RESULTS: Seventeen highly myopic eyes in 16 patients with a mean axial length of 30.49 ± 0.98 mm and mean age of 62.25 ± 9.40 years were included in this study, including five eyes with foveoschisis and four eyes with chronic MH, two with myopic choroidal neovascularization, and four with MH-associated retinal detachment. The MHs of all patients were successfully closed after a single operation. All of the patients were followed for at least 6 months. The average visual acuity in logarithm of minimal angle of resolution improved from 1.26 ± 0.52 preoperatively to 0.69 ± 0.45 6 months postoperatively (p = 0.01, paired t-test). CONCLUSION: A large semicircular inverted ILM flap can close a myopic MH efficiently without the need for a long-term face-down position.
PURPOSE: To describe the technique and surgical outcomes of a modified large semicircular inverted internal limiting membrane (ILM) flap in the management of macular holes (MHs) in patients with high myopia. METHODS: We performed this retrospective study on consecutive patients with MH and high myopia (axial length ≥ 28 mm),who received vitrectomy, a large semicircular ILM flap 4 discs in diameter to cover the MH, incomplete air-fluid exchange, and SF6 gas tamponade. All of the patients maintained an upright position for 2 h postoperatively, followed by either a face-down or upright position for 1 week. Post-operative visual acuity was measured, and MH status was assessed using spectral-domain optical coherence tomography. RESULTS: Seventeen highly myopic eyes in 16 patients with a mean axial length of 30.49 ± 0.98 mm and mean age of 62.25 ± 9.40 years were included in this study, including five eyes with foveoschisis and four eyes with chronic MH, two with myopic choroidal neovascularization, and four with MH-associated retinal detachment. The MHs of all patients were successfully closed after a single operation. All of the patients were followed for at least 6 months. The average visual acuity in logarithm of minimal angle of resolution improved from 1.26 ± 0.52 preoperatively to 0.69 ± 0.45 6 months postoperatively (p = 0.01, paired t-test). CONCLUSION: A large semicircular inverted ILM flap can close a myopic MH efficiently without the need for a long-term face-down position.