Jie Peng1, Li-Hua Zhang2, Chun-Li Chen3,4, Jing-Jing Liu1, Xiu-Yu Zhu1, Pei-Quan Zhao1. 1. Department of Ophthalmology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China. 2. Department of Ophthalmology, Binzhou Hubin Aier Eye Hospital, Binzhou 256600, Shandong Province, China. 3. Department of Ophthalmology, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 200022, China. 4. Department of Ophthalmology, Shengli Oilfield Central Hospital, Dongying 257034, Shandong Province, China.
Abstract
AIM: To introduce a modified technique of internal limiting membrane (ILM) centripetal dragging and peeling to treat idiopathic macular hole (IMH) and to observe the ILM-retina adhesive forces. METHODS: Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled. All patients underwent complete par plana vitrectomy, ILM dragging and peeling, fluid and gas exchange, 15% C3F8 tamponade and 2-week prone position. The best corrected visual acuity, macular hole evaluation by optical coherence tomography, and complications were evaluated. RESULTS: The mean diameter of IMH was 524±148 µm (range: 201-683 µm), with 21 cases (80.8%) greater than 400 µm. ILM dragging and peeling were successfully performed in all cases. Most of the ILM-retina adhesive forces are severe (42.3%, 11/26), followed by mild (38.5%, 10/26), and moderate (19.2%, 5/26). The mean follow-up duration was 21.2±6.1mo. The IMH was closed in 25 (96.3%) eyes. Visual acuity (logMAR) improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively (P<0.001). CONCLUSION: Preexisting ILM-retina adhesive force is found in IMH patients. With assistance of this force, this modified technique may help to release the IMH edges and improve the closure rate of large IMH. International Journal of Ophthalmology Press.
AIM: To introduce a modified technique of internal limiting membrane (ILM) centripetal dragging and peeling to treat idiopathic macular hole (IMH) and to observe the ILM-retina adhesive forces. METHODS: Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled. All patients underwent complete par plana vitrectomy, ILM dragging and peeling, fluid and gas exchange, 15% C3F8 tamponade and 2-week prone position. The best corrected visual acuity, macular hole evaluation by optical coherence tomography, and complications were evaluated. RESULTS: The mean diameter of IMH was 524±148 µm (range: 201-683 µm), with 21 cases (80.8%) greater than 400 µm. ILM dragging and peeling were successfully performed in all cases. Most of the ILM-retina adhesive forces are severe (42.3%, 11/26), followed by mild (38.5%, 10/26), and moderate (19.2%, 5/26). The mean follow-up duration was 21.2±6.1mo. The IMH was closed in 25 (96.3%) eyes. Visual acuity (logMAR) improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively (P<0.001). CONCLUSION: Preexisting ILM-retina adhesive force is found in IMH patients. With assistance of this force, this modified technique may help to release the IMH edges and improve the closure rate of large IMH. International Journal of Ophthalmology Press.
Entities:
Keywords:
adhesive force; idiopathic macular hole; internal limiting membrane; par plana vitrectomy
Authors: Michael S Ip; Brad J Baker; Jay S Duker; Elias Reichel; Caroline R Baumal; Ronald Gangnon; Carmen A Puliafito Journal: Arch Ophthalmol Date: 2002-01
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