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Long-term surgical outcomes of the inverted internal limiting membrane flap technique in highly myopic macular hole retinal detachment

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Pars plana vitrectomy (PPV) procedures are used for the surgical treatment of macular hole retinal detachment (MHRD) associated with high myopia. Re-detachment of the retina has been reported in MHRD associated with high myopia. Our aim was to evaluate the 1-year outcomes of vitrectomy, performed using an inverted internal limiting membrane (ILM) flap technique with gas tamponade, in five cases of MHRD associated with high myopia.

Methods

We performed a retrospective review of medical records of five consecutive cases of highly myopic MHRD. The following postoperative data were collected: refractive error, best-corrected visual acuity, intraocular pressure, ophthalmic fundus examination findings, ocular coherence tomography at 1, 3, 6, and 12 months postoperatively; duration of the follow-up period; and intra- and postoperative complications. The primary endpoint of the study was the rate of postoperative retinal reattachment and macular hole (MH) closure. Paired t-tests were conducted to evaluate postoperative changes.

Results

Mean visual acuity improved significantly (P = 0.008), with an improvement of ≥2 lines on LogMAR value gained in three of the five eyes. Retinal reattachment was maintained in all cases, with no cases of MH reopening identified over the mean follow-up period of 20.2 months. No complications were identified in any eye.

Conclusions

The inverted ILM flap technique and gas tamponade provided primary retinal reattachment and MH closure over the ≥12-month follow-up period.

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Acknowledgements

This research was not support by funding from the public, commercial, or not-for-profit sectors. The authors have no financial disclosures to report.

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Authors and Affiliations

  1. Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura City, Chiba, 285-0841, Japan

    Taiga Kinoshita, Yasutaka Onoda & Takatoshi Maeno

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  1. Taiga Kinoshita
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  2. Yasutaka Onoda
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  3. Takatoshi Maeno
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Corresponding author

Correspondence to Taiga Kinoshita.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Electronic supplementary material

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This intraoperative OCT video was recorded after fluid-air exchange without draining the SRF through the MH. In this video, the posterior retina appeared dome shaped, over the submacular fluid, with the ILM covering the MH. (MP4 6060 kb)

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Kinoshita, T., Onoda, Y. & Maeno, T. Long-term surgical outcomes of the inverted internal limiting membrane flap technique in highly myopic macular hole retinal detachment. Graefes Arch Clin Exp Ophthalmol 255, 1101–1106 (2017). https://doi.org/10.1007/s00417-017-3614-0

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  • DOI: https://doi.org/10.1007/s00417-017-3614-0

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