Brief Communications October 2013
Surgical outcomes of inverted internal limiting membrane flap technique for large macular hole Prabhushanker Mahalingam, Kumar Sambhav We are presenting the initial results of inverted internal limiting membrane (ILM) flap technique for large macular hole. Five eyes of five patients with large diameter macular hole (>700 µm) were selected. All patients underwent inverted ILM flap technique for macular hole. Anatomical closure and functional success were achieved in all patients. There was no loss of best‑corrected visual acuity in any of the patients. Inverted ILM flap technique in macular hole surgery seems to have a better hole closure rates, especially in large diameter macular holes. Larger case series is required to assess the efficacy and safety of this technique. Key words: Inverted internal limiting membrane flap technique, macular hole, macular hole surgery
Full‑thickness macular holes are a relatively common cause of a significant reduction in central visual acuity. In 1988, Gass proposed a classification system for idiopathic macular holes, as well as a new hypothesis for its pathogenesis, which emphasizes the role of the vitreo‑macular tangential traction in the formation of macular holes.[1] Macular hole surgery is a well‑established method for the treatment of idiopathic macular holes. The rationale for surgery is the identification and treatment of these vitreo‑retinal traction forces, either tangential, antero‑posterior or both. The procedure for macular hole surgery is pars plana vitrectomy, posterior vitreous removal, internal limiting membrane (ILM) peeling, filling of the vitreous cavity with a gas bubble and post‑operative face‑down positioning for 1 week.[2,3] This is a conventional procedure in cases with small to moderate holes but in cases with large holes, the anatomical and functional success is difficult to achieve. The inverted ILM flap technique improves both functional and anatomical outcome Access this article online Quick Response Code:
Website: www.ijo.in DOI: 10.4103/0301-4738.121090 PMID: ***
Department of Vitreo‑Retina, Sankara Eye Care Institutions, Coimbatore, Tamil Nadu, India Correspondence to: Dr. Prabhushanker Mahalingam, Sankara Eye Centre, Sathy Road, Sivanandapuram, Coimbatore, Tamil Nadu, India. E‑mail: [email protected] Manuscript received: 05.04.13; Revision accepted: 05.06.13
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following vitrectomy, for large macular holes.[4] This study was done to present the initial surgical results of this technique.
Materials and Methods It was a prospective, non‑randomized, interventional case‑series study of patients with large macular holes. All patients in the study had idiopathic large macular holes as determined by bio microscopy and optical coherence tomography (OCT) imaging. Exclusion criteria were macular holes of
Surgical outcomes of inverted internal limiting membrane flap technique for large macular hole Prabhushanker Mahalingam, Kumar Sambhav We are presenting the initial results of inverted internal limiting membrane (ILM) flap technique for large macular hole. Five eyes of five patients with large diameter macular hole (>700 µm) were selected. All patients underwent inverted ILM flap technique for macular hole. Anatomical closure and functional success were achieved in all patients. There was no loss of best‑corrected visual acuity in any of the patients. Inverted ILM flap technique in macular hole surgery seems to have a better hole closure rates, especially in large diameter macular holes. Larger case series is required to assess the efficacy and safety of this technique. Key words: Inverted internal limiting membrane flap technique, macular hole, macular hole surgery
Full‑thickness macular holes are a relatively common cause of a significant reduction in central visual acuity. In 1988, Gass proposed a classification system for idiopathic macular holes, as well as a new hypothesis for its pathogenesis, which emphasizes the role of the vitreo‑macular tangential traction in the formation of macular holes.[1] Macular hole surgery is a well‑established method for the treatment of idiopathic macular holes. The rationale for surgery is the identification and treatment of these vitreo‑retinal traction forces, either tangential, antero‑posterior or both. The procedure for macular hole surgery is pars plana vitrectomy, posterior vitreous removal, internal limiting membrane (ILM) peeling, filling of the vitreous cavity with a gas bubble and post‑operative face‑down positioning for 1 week.[2,3] This is a conventional procedure in cases with small to moderate holes but in cases with large holes, the anatomical and functional success is difficult to achieve. The inverted ILM flap technique improves both functional and anatomical outcome Access this article online Quick Response Code:
Website: www.ijo.in DOI: 10.4103/0301-4738.121090 PMID: ***
Department of Vitreo‑Retina, Sankara Eye Care Institutions, Coimbatore, Tamil Nadu, India Correspondence to: Dr. Prabhushanker Mahalingam, Sankara Eye Centre, Sathy Road, Sivanandapuram, Coimbatore, Tamil Nadu, India. E‑mail: [email protected] Manuscript received: 05.04.13; Revision accepted: 05.06.13
601
following vitrectomy, for large macular holes.[4] This study was done to present the initial surgical results of this technique.
Materials and Methods It was a prospective, non‑randomized, interventional case‑series study of patients with large macular holes. All patients in the study had idiopathic large macular holes as determined by bio microscopy and optical coherence tomography (OCT) imaging. Exclusion criteria were macular holes of
