Pedicle internal limiting membrane flap technique for very large macular holes: a preliminary report

被引:4
作者
da Silva Tavares Neto, Jose Edisio [1 ]
Coelho, Igor Neves [1 ]
Jorge, Rodrigo [1 ]
Cruvinel Isaac, David Leonardo [2 ]
de Avila, Marcos Pereira [2 ]
机构
[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Ophthalmol, 3900. Bandeirantes Ave, BR-14049900 Ribeirao Preto, SP, Brazil
[2] Univ Fed Goias, Dept Ophthalmol, Goiania, Go, Brazil
关键词
Retina; Macula lutea; Macular hole; Vitreous; Vitrectomy; Inner limiting membrane; OPTICAL COHERENCE TOMOGRAPHY; AUTOLOGOUS SERUM; FELLOW EYES; SURGERY; PREVALENCE; URBAN; CLASSIFICATION; POPULATION;
D O I
10.1186/s40942-020-00248-7
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
BackgroundConventional vitrectomy technique for macular hole surgery has a good outcome in small and medium macular holes, but for very large macular holes (minimum linear diameter higher than 700 mu m) other techniques were developed aiming to achieve greater rates of closure and visual acuity gain. The purpose of this article is to report the anatomical and functional outcomes of four very large macular hole (MH) cases which have undergone vitrectomy with the pedicle internal limiting membrane (ILM) flap technique.MethodsThis is a retrospective series of four patients with large MH who were treated with vitrectomy and the pedicle ILM flap technique. Comprehensive ophthalmologic evaluation was performed before surgery and included ETDRS best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT) for MH measures: height, minimum linear diameter (MLD) and external base diameter. The particular detail of this technique is related to ILM flap creation. During the peeling, the ILM was not removed completely from the retina but was left attached to the edges of the macular hole and subsequently trimmed with the vitrectomy probe using the scissors mode.ResultsFour patients with very large MH underwent PPV and the pedicle ILM flap technique was used to pursue macular closure. Median preoperative BCVA was 20/400 (range: 20/320 to 20/400) and median postoperative BCVA was 20/200 (range: 20/320 to 20/200). Of the 4 cases reported, 3 obtained anatomical closure (75%), and also presented BCVA improvement after surgery, considering the last follow-up visit of each case. No additional procedures were performed in either case. One patient demonstrated no anatomic and functional improvement.ConclusionThe present study describes the first Brazilian case series of very large MH treated by the inverted pedicle ILM flap technique. This technique was associated with anatomic and visual improvement in most cases, and represents an alternative therapeutic approach for large macular holes.Trial Registration Project registered in Plataforma Brasil with CAAE number 30163520.0.0000.5440 and approved in ethics committee from RibeirAo Preto Medical School Clinics Hospital, University of SAo Paulo-RibeirAo Preto, SAo Paulo, Brazil (appreciation number 3.948.426 gave the approval).
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页数:8
相关论文
共 40 条
[1]   MACULAR HOLES [J].
AABERG, TM ;
BLAIR, CJ ;
GASS, DM .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 1970, 69 (04) :555-&
[2]  
AKIBA J, 1992, OPHTHALMIC SURG LAS, V23, P594
[3]  
[Anonymous], 1994, Am J Ophthalmol, V118, P754
[4]   Macular hole surgery with and without internal limiting membrane peeling [J].
Brooks, HL .
OPHTHALMOLOGY, 2000, 107 (10) :1939-1948
[5]   Re-operation of idiopathic full-thickness macular holes after initial surgery with internal limiting membrane peel [J].
D'Souza, Mark J. J. ;
Chaudhary, Varun ;
Devenyi, Robert ;
Kertes, Peter J. ;
Lam, Wai-Ching .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2011, 95 (11) :1564-1567
[6]   Autologous Internal Limiting Membrane Fragment Transplantation for Large, Chronic, and Refractory Macular Holes [J].
De Novelli, Fernando Jose ;
Preti, Rony Carlos ;
Ribeiro Monteiro, Mario Luiz ;
Pelayes, David E. ;
Nobrega, Mario Junqueira ;
Takahashi, Walter Yukihiko .
OPHTHALMIC RESEARCH, 2016, 55 (01) :45-52
[7]   The International Vitreomacular Traction Study Group Classification of Vitreomacular Adhesion, Traction, and Macular Hole [J].
Duker, Jay S. ;
Kaiser, Peter K. ;
Binder, Susanne ;
de Smet, Marc D. ;
Gaudric, Alain ;
Reichel, Elias ;
Sadda, SriniVas R. ;
Sebag, Jerry ;
Spaide, Richard F. ;
Stalmans, Peter .
OPHTHALMOLOGY, 2013, 120 (12) :2611-2619
[8]   Systemic risk factors for idiopathic macular holes: a case-control study [J].
Evans, JR ;
Schwartz, SD ;
McHugh, JDA ;
Thamby-Rajah, Y ;
Hodgson, SA ;
Wormald, RPL ;
Gregor, ZJ .
EYE, 1998, 12 (2) :256-259
[9]   Surgery for idiopathic full-thickness macular hole - Two-year results of a randomized clinical trial comparing natural history, vitrectomy, and vitrectomy plus autologous serum: Moorfields macular hole study group report No. 1 [J].
Ezra, E ;
Gregor, ZJ .
ARCHIVES OF OPHTHALMOLOGY, 2004, 122 (02) :224-236
[10]   Incidence of idiopathic full-thickness macular holes in fellow eyes -: A 5-year prospective natural history study [J].
Ezra, E ;
Wells, JA ;
Gray, RH ;
Kinsella, FMP ;
Orr, GM ;
Grego, J ;
Arden, GB ;
Gregor, ZJ .
OPHTHALMOLOGY, 1998, 105 (02) :353-359