Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal

Purpose. To investigate the microstructural changes after successful myopic macular hole (MMH) surgery, comparing inverted ILM flap and complete ILM removal techniques, and their association with visual function. Methods. Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate bot...

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Main Authors: Maurizio Mete, Alessandro Alfano, Emilia Maggio, Massimo Guerriero, Grazia Pertile
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2019/1314989
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author Maurizio Mete
Alessandro Alfano
Emilia Maggio
Massimo Guerriero
Grazia Pertile
author_facet Maurizio Mete
Alessandro Alfano
Emilia Maggio
Massimo Guerriero
Grazia Pertile
author_sort Maurizio Mete
collection DOAJ
description Purpose. To investigate the microstructural changes after successful myopic macular hole (MMH) surgery, comparing inverted ILM flap and complete ILM removal techniques, and their association with visual function. Methods. Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate both external limiting membrane (ELM) and ellipsoid zone (EZ) recovery in 40 eyes of 39 patients who underwent pars plana vitrectomy with either inverted internal limiting membrane flap technique (n=27) or complete ILM removal (n=13) to achieve MH closure. The association between ELM and EZ recovery and visual acuity was also investigated. The patients were followed up at 1 year. Results. ELM and EZ was recovered in 72% and 62% of cases, respectively, regardless of the surgical techniques 1 year after surgery. A strong positive association between the ELM and EZ recovery and the mean BCVA was found: regardless of the surgical technique, this was statistically significant at each time point (p<0.05). None of the baseline variables were found to act as predictive factors for either ELM or EZ. Conclusion. The inverted ILM flap technique did not affect the MMH healing processes compared to complete ILM removal. Thus, the presence of the ILM plug did not interfere with the restoration of both ELM and EZ, which correlated with functional recovery.
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institution Kabale University
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publishDate 2019-01-01
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spelling doaj-art-88b5318481634b098d3ed44f06ec9d582025-02-03T01:29:13ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/13149891314989Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM RemovalMaurizio Mete0Alessandro Alfano1Emilia Maggio2Massimo Guerriero3Grazia Pertile4Department of Ophthalmology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, ItalyDepartment of Ophthalmology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, ItalyDepartment of Ophthalmology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, ItalyDepartment of Computer Science, University of Verona, Verona, ItalyDepartment of Ophthalmology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, ItalyPurpose. To investigate the microstructural changes after successful myopic macular hole (MMH) surgery, comparing inverted ILM flap and complete ILM removal techniques, and their association with visual function. Methods. Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate both external limiting membrane (ELM) and ellipsoid zone (EZ) recovery in 40 eyes of 39 patients who underwent pars plana vitrectomy with either inverted internal limiting membrane flap technique (n=27) or complete ILM removal (n=13) to achieve MH closure. The association between ELM and EZ recovery and visual acuity was also investigated. The patients were followed up at 1 year. Results. ELM and EZ was recovered in 72% and 62% of cases, respectively, regardless of the surgical techniques 1 year after surgery. A strong positive association between the ELM and EZ recovery and the mean BCVA was found: regardless of the surgical technique, this was statistically significant at each time point (p<0.05). None of the baseline variables were found to act as predictive factors for either ELM or EZ. Conclusion. The inverted ILM flap technique did not affect the MMH healing processes compared to complete ILM removal. Thus, the presence of the ILM plug did not interfere with the restoration of both ELM and EZ, which correlated with functional recovery.http://dx.doi.org/10.1155/2019/1314989
spellingShingle Maurizio Mete
Alessandro Alfano
Emilia Maggio
Massimo Guerriero
Grazia Pertile
Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
Journal of Ophthalmology
title Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
title_full Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
title_fullStr Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
title_full_unstemmed Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
title_short Inverted ILM Flap for the Treatment of Myopic Macular Holes: Healing Processes and Morphological Changes in Comparison with Complete ILM Removal
title_sort inverted ilm flap for the treatment of myopic macular holes healing processes and morphological changes in comparison with complete ilm removal
url http://dx.doi.org/10.1155/2019/1314989
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