TY - JOUR
T1 - MANAGEMENT OF LARGE FULL-THICKNESS MACULAR HOLES
T2 - Long-Term Outcomes of Internal Limiting Membrane Flaps and Internal Limiting Membrane Peels
AU - Richards, Kaitlyn
AU - Kadakia, Ankit
AU - Wykoff, Charles C.
AU - Major, James C.
AU - Wong, Tien P.
AU - Chen, Eric
AU - Schefler, Amy C.
AU - Patel, Sagar B.
AU - Kim, Rosa Y.
AU - Henry, Christopher R.
AU - Fish, Richard H.
AU - Brown, David M.
AU - Benz, Matthew S.
AU - Pearce, William
AU - Shah, Ankoor R.
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/7/1
Y1 - 2024/7/1
N2 - BACKGROUND/PURPOSE: To determine and compare the efficacy of a surgical internal limiting membrane (ILM) flap technique with the traditional ILM peel on long-term visual and anatomical outcomes for large (>400 µm) full-thickness macular holes.METHODS: From October 2016 to July 2022, patients undergoing initial full-thickness macular hole repair with the ILM flap or ILM peel technique were reviewed. Final outcomes were recorded and based on size in microns: 401 to 800, 801 to 1,200, and >1,200.RESULTS: Patients treated with ILM flap (n = 52, 94.2% closure rate) or ILM peel (n = 407, 93.6% closure rate) were followed with a mean follow-up time of 15.0 ± 10.2 and 20.0 ± 13.4 months, respectively. Success rates for ILM flaps and ILM peels were compared for full-thickness macular holes of 401 to 800 (100%, 95.8%, P = 0.39), 801 to 1,200 (95%, 93%, P = 0.74), and >1,200 (86.7%, 86.7%, P = 1.0) µm. Mean best-recorded logarithm of the minimal angle of resolution visual acuity for ILM flaps and ILM peels, respectively, was 1.02 ± 0.46 and 0.87 ± 0.47 preoperatively, with follow-up acuity of 0.48 ± 0.32 (P < 0.03) and 0.39 ± 0.42 (P < 0.01) at Year 3.CONCLUSION: Both techniques provide a similar anatomical closure rate and functional improvement in vision. Comparisons should be cautiously made based on difference in preoperative hole size.
AB - BACKGROUND/PURPOSE: To determine and compare the efficacy of a surgical internal limiting membrane (ILM) flap technique with the traditional ILM peel on long-term visual and anatomical outcomes for large (>400 µm) full-thickness macular holes.METHODS: From October 2016 to July 2022, patients undergoing initial full-thickness macular hole repair with the ILM flap or ILM peel technique were reviewed. Final outcomes were recorded and based on size in microns: 401 to 800, 801 to 1,200, and >1,200.RESULTS: Patients treated with ILM flap (n = 52, 94.2% closure rate) or ILM peel (n = 407, 93.6% closure rate) were followed with a mean follow-up time of 15.0 ± 10.2 and 20.0 ± 13.4 months, respectively. Success rates for ILM flaps and ILM peels were compared for full-thickness macular holes of 401 to 800 (100%, 95.8%, P = 0.39), 801 to 1,200 (95%, 93%, P = 0.74), and >1,200 (86.7%, 86.7%, P = 1.0) µm. Mean best-recorded logarithm of the minimal angle of resolution visual acuity for ILM flaps and ILM peels, respectively, was 1.02 ± 0.46 and 0.87 ± 0.47 preoperatively, with follow-up acuity of 0.48 ± 0.32 (P < 0.03) and 0.39 ± 0.42 (P < 0.01) at Year 3.CONCLUSION: Both techniques provide a similar anatomical closure rate and functional improvement in vision. Comparisons should be cautiously made based on difference in preoperative hole size.
KW - ILM flap
KW - chronic
KW - full-thickness macular hole
KW - internal limiting membrane
KW - large
KW - membrane peel
KW - Vitrectomy/methods
KW - Surgical Flaps
KW - Retinal Perforations/surgery
KW - Follow-Up Studies
KW - Tomography, Optical Coherence
KW - Humans
KW - Middle Aged
KW - Male
KW - Treatment Outcome
KW - Visual Acuity/physiology
KW - Endotamponade/methods
KW - Time Factors
KW - Epiretinal Membrane/surgery
KW - Female
KW - Retrospective Studies
KW - Aged
KW - Basement Membrane/surgery
UR - http://www.scopus.com/inward/record.url?scp=85196872258&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85196872258&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000004099
DO - 10.1097/IAE.0000000000004099
M3 - Article
C2 - 38900578
AN - SCOPUS:85196872258
SN - 0275-004X
VL - 44
SP - 1165
EP - 1170
JO - Retina
JF - Retina
IS - 7
ER -