Ho Ra1, Won Ki Lee1. 1. a Department of Ophthalmology & Visual Science , College of Medicine, The Catholic University of Korea , Seoul , Korea.
Abstract
PURPOSE: The aim of the present study was to evaluate the efficacy of the inverted internal limiting membrane (ILM) flap technique that involved the use of a perfluorocarbon liquid (PFCL) bubble for the selective prevention of indocyanine green (ICG) staining of the parts of the inverted flap in contact with the retinal pigment epithelium for large macular hole (MH) closure. MATERIALS AND METHODS: This retrospective, interventional, comparative study included 26 patients with idiopathic large MHs (minimum diameter, > 400 µm) who underwent vitrectomy using the inverted ILM flap technique with conventional ILM staining with ICG (n = 14, Group 1) or PFCL-mediated selective ILM staining with ICG (n = 12, Group 2). The hole closure rate, best-corrected visual acuity (BCVA), and optical coherence tomography findings were analyzed at baseline and 1, 3, and 6 months after surgery in both groups. RESULTS: Hole closure was achieved in all the eyes. BCVA significantly improved after surgery in both groups (p < 0.001 for both groups), although Group 2 exhibited significantly better values at 3 and 6 months after surgery (p = 0.008 and 0.001 at 3 and 6 months, respectively). The sizes of ellipsoid zone defect significantly decreased after surgery in both groups (p < 0.001 relative to the baseline width in both groups), and it was significantly smaller in Group 2 than in Group 1 at 3 (p = 0.006) and 6 (p = 0.001) months after surgery. CONCLUSIONS: The findings of this study suggest that recovery of the photoreceptor layers and, consequently, the postoperative VA are better with the inverted ILM flap technique employing PFCL-mediated selective ILM staining with ICG than with the technique employing conventional ILM staining with ICG methods for patients with large MHs.
PURPOSE: The aim of the present study was to evaluate the efficacy of the inverted internal limiting membrane (ILM) flap technique that involved the use of a perfluorocarbon liquid (PFCL) bubble for the selective prevention of indocyanine green (ICG) staining of the parts of the inverted flap in contact with the retinal pigment epithelium for large macular hole (MH) closure. MATERIALS AND METHODS: This retrospective, interventional, comparative study included 26 patients with idiopathic large MHs (minimum diameter, > 400 µm) who underwent vitrectomy using the inverted ILM flap technique with conventional ILM staining with ICG (n = 14, Group 1) or PFCL-mediated selective ILM staining with ICG (n = 12, Group 2). The hole closure rate, best-corrected visual acuity (BCVA), and optical coherence tomography findings were analyzed at baseline and 1, 3, and 6 months after surgery in both groups. RESULTS: Hole closure was achieved in all the eyes. BCVA significantly improved after surgery in both groups (p < 0.001 for both groups), although Group 2 exhibited significantly better values at 3 and 6 months after surgery (p = 0.008 and 0.001 at 3 and 6 months, respectively). The sizes of ellipsoid zone defect significantly decreased after surgery in both groups (p < 0.001 relative to the baseline width in both groups), and it was significantly smaller in Group 2 than in Group 1 at 3 (p = 0.006) and 6 (p = 0.001) months after surgery. CONCLUSIONS: The findings of this study suggest that recovery of the photoreceptor layers and, consequently, the postoperative VA are better with the inverted ILM flap technique employing PFCL-mediated selective ILM staining with ICG than with the technique employing conventional ILM staining with ICG methods for patients with large MHs.