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

  • Taiga KinoshitaEmail author
  • Yasutaka Onoda
  • Takatoshi Maeno
Retinal Disorders

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.

Keywords

Inverted internal limiting membrane flap technique Highly myopic macular hole retinal detachment 

Notes

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.

Compliance with ethical standards

For this type of study formal consent is not required.

Funding

No funding was received for this research.

Conflict of interest

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.

Supplementary material

VIDEO 1

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)

References

  1. 1.
    Gonvers M, Machemer R (1982) A new approach to treating retinal detachment with macular hole. Am J Ophthalmol 94:468–472CrossRefPubMedGoogle Scholar
  2. 2.
    Stirpe M, Michels RG (1990) Retinal detachment in highly myopic eyes due to macular holes and epiretinal traction. Retina 10:113–114CrossRefPubMedGoogle Scholar
  3. 3.
    Oshima Y, Ikuno Y, Motokura M, Nakae K, Tano Y (1998) Complete epiretinal membrane separation in highly myopic eyes with retinal detachment resulting from a macular hole. Am J Ophthalmol 126:669–676. doi: 10.1016/S0002-9394(98)00180-9 CrossRefPubMedGoogle Scholar
  4. 4.
    Kadonosono K, Yazama F, Itoh N, Uchio E, Nakamura S, Akura J, Sawada H, Ohno S (2001) Treatment of retinal detachment resulting from myopic macular hole with internal limiting membrane removal. Am J Ophthalmol 131:203–207. doi: 10.1016/S0002-9394(00)00728-5 CrossRefPubMedGoogle Scholar
  5. 5.
    Ichibe M, Yoshizawa T, Murakami K, Ohta M, Oya Y, Yamamoto S, Funaki S, Funaki H, Ozawa Y, Baba E, Abe H (2003) Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula. Am J Ophthalmol 136:277–284. doi: 10.1016/S0002-9394(03)00186-7 CrossRefPubMedGoogle Scholar
  6. 6.
    Uemoto R, Saito Y, Sato S, Imaizumi A, Tanaka M, Nakae K (2003) Better success of retinal reattachment with long-standing gas tamponade in highly myopic eyes. Graefes Arch Clin Exp Ophthalmol 241:792–796. doi: 10.1007/s00417-003-0750-5 CrossRefPubMedGoogle Scholar
  7. 7.
    Ando F, Ohba N, Touura K, Hirose H (2007) Anatomical and visual outcomes after episcleral macular buckling compared with those after pars plana vitrectomy for retinal detachment caused by macular hole in highly myopic eyes. Retina 27:37–44. doi: 10.1097/01.iae.0000256660.48993.9e CrossRefPubMedGoogle Scholar
  8. 8.
    Oie Y, Emi K, Takaoka G, Ikeda T (2007) Effect of indocyanine green staining in peeling of internal limiting membrane for retinal detachment resulting from macular hole in myopic eyes. Ophthalmology 114:303–306. doi: 10.1016/j.ophtha.2006.07.052 CrossRefPubMedGoogle Scholar
  9. 9.
    Nakanishi H, Kuriyama S, Saito I, Okada M, Kita M, Kurimoto Y, Kimura H, Takagi H, Yoshimura N (2008) Prognostic factor analysis in pars plana vitrectomy for retinal detachment attributable to macular hole in high myopia: a multicenter study. Am J Ophthalmol 146:198–204. doi: 10.1016/j.ajo.2008.04.022 CrossRefPubMedGoogle Scholar
  10. 10.
    Alkabes M, Bures-Jelstrup A, Salinas C, Medeiros MD, Rios J, Corcostegui B, Mateo C (2014) Macular buckling for previously untreated and recurrent retinal detachment due to high myopic macular hole: a 12-month comparative study. Graefes Arch Clin Exp Ophthalmol 252:571–581. doi: 10.1007/s00417-013-2497 CrossRefPubMedGoogle Scholar
  11. 11.
    Arias L, Caminal JM, Rubio MJ, Cobos E, Garcia-Bru P, Filloy A, Padron N, Mejia K (2015) Autofluorescence and axial length as prognostic factors for outcomes of macular hole retinal detachment surgery in high myopia. Retina 35:423–428. doi: 10.1097/IAE.0000000000000335 CrossRefPubMedGoogle Scholar
  12. 12.
    Nishimura A, Kimura M, Saito Y, Sugiyama K (2011) Efficacy of primary silicone oil tamponade for the treatment of retinal detachment caused by macular hole in high myopia. Am J Ophthalmol 151:148–155. doi: 10.1016/j.ajo.2010.07.023 CrossRefPubMedGoogle Scholar
  13. 13.
    Morita H, Ideta H, Ito K, Yonemoto J, Sasaki K, Tanaka S (1991) Causative factors of retinal detachment in macular holes. Retina 11:281–284CrossRefPubMedGoogle Scholar
  14. 14.
    Ikuno Y, Sayanagi K, Oshima T, Gomi F, Kusaka S, Kamei M, Ohji M, Fuhikado T, Tano Y (2003) Optical coherence tomographic findings of macular holes and retinal detachment after vitrectomy in highly myopic eyes. Am J Ophthalmol 136:477–481. doi: 10.1016/S0002-9394(03)00269-1 CrossRefPubMedGoogle Scholar
  15. 15.
    Seike C, Kusaka S, Sakagami K, Ohashi Y (1997) Reopening of macular holes in highly myopic eyes with retinal detachments. Retina 117:2–6. doi: 10.1016/j.ophtha.2010.02.011 CrossRefGoogle Scholar
  16. 16.
    Michalewska Z, Michalewski J, Adelman RA, Nawrocki J (2010) Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology 117:2018–2025. doi: 10.1016/j.ophtha.2010.02.011 CrossRefPubMedGoogle Scholar
  17. 17.
    Lai CC, Chen YP, Wang NK, Chuang LH, Liu L, Chen KJ, Hwang YS, Wu WC, Chen TL (2015) Vitrectomy with internal limiting membrane repositioning and autologous blood for macular hole retinal detachment in highly myopic eyes. Ophthalmology 122:1889–1898. doi: 10.1016/j.ophtha.2015.05.040 CrossRefPubMedGoogle Scholar
  18. 18.
    Chen SN, Yang CM (2016) Inverted internal limiting membrane insertion for macular hole-associated retinal detachment in high myopia. Am J Ophthalmol 162:99–106.e1. doi: 10.1016/j.ajo.2015.11.013 CrossRefPubMedGoogle Scholar
  19. 19.
    Kuriyama S, Hayashi H, Jingami Y, Kuramoto N, Akita J, Matsumoto M (2013) Efficacy of inverted internal limiting membrane flap technique for the treatment of macular hole in high myopia. Am J Ophthalmol 156:125–131.e1. doi: 10.1016/j.ajo.2013.02.014 CrossRefPubMedGoogle Scholar
  20. 20.
    Yamamoto N, Ozaki N, Murakami K (2004) Triamcinolone acetonide facilitates removal of the epiretinal membrane and separation of the residual vitreous cortex in highly myopic eyes with retinal detachment due to a macular hole. Ophthalmologica 218:248–256. doi: 10.1159/000078615 CrossRefPubMedGoogle Scholar
  21. 21.
    Ehlers JP, Kaiser PK, Srivastava SK (2014) Intraoperative optical coherence tomography using the RESCAN 700: preliminary results from the DISCOVER study. Br J Ophthalmol 98:1329–1332. doi: 10.1136/bjophthalmol-2014-305294 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Pfau M, Michels S, Binder S, Becker MD (2015) Clinical experience with the first commercially available intraoperative optical coherence tomography system. Ophthalmic Surg Lasers Imaging Retin 46:1001–1008. doi: 10.3928/23258160-20151027-03 CrossRefGoogle Scholar
  23. 23.
    Okuda T, Higashide T, Kobayashi K, Ikuno Y, Sugiyama K (2016) Macular hole closure over residual subretinal fluid by an inverted internal limiting membrane flap technique in patients with macular hole retinal detachment in high myopia. Retin Cases Brief Rep 10:140–144. doi: 10.1097/ICB.0000000000000205 CrossRefPubMedGoogle Scholar
  24. 24.
    Enaida H, Hisatomi T, Hata Y, Ueno A, Goto Y, Yamada T, Kubota T, Ishibashi T (2006) Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling. Retina 26:631–636. doi: 10.1097/01.iae.0000236469.71443.aa PubMedGoogle Scholar
  25. 25.
    Shao Q, Xia H, Heussen FM, Ouyang Y, Sun X, Fan Y (2015) Postoperative anatomical and functional outcomes of different stages of high myopia macular hole. BMC Ophthalmol 15:93. doi: 10.1186/s12886-015-0098-8 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of OphthalmologyToho University Sakura Medical CenterSakura CityJapan

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