Vitrectomy with C-shaped temporal inverted limiting membrane flap to reconstruct foveola architecture for macular hole retinal detachment in highly myopic eyes

Session Details

Session Title: Free Paper Session 13: Vitreoretinal Surgery IV

Session Date/Time: Friday 08/09/2017 | 14:30-16:00

Paper Time: 14:36

Venue: Room 117

First Author: : T.Ho TAIWAN

Co Author(s): :                                 

Abstract Details

Purpose:

To investigate the surgical results of macular hole retinal detachment (MHRD) with C-shaped temporal inverted internal limiting membrane (ILM) flap to reconstruct foveola architecture in highly myopic eyes.

Setting:

Interventional case series

Methods:

Thirty cases of highly myopic eyes with MHRD in twenty-nine patients who underwent a vitrectomy combined with C-Shaped temporal inverted ILM flap were followed up over 12 months were reviewed. The anatomic outcomes of MHRD were evaluated by fundus examinations and optical coherence tomography. The preoperative and postoperative best-corrected visual acuities (BCVAs) were compared as the functional outcome.

Results:

In total, women accounted for 66% (17/29) of the MHRD patients. The mean age was 62.2 years. The mean axial length was 29.85 mm. Type 1 MHRD was present in 8 eyes, and type 2 MHRD was present in 22 eyes. After a single surgery, the hole was closed in 30 eyes (100%), and 97% (29/30) retinal reattachment was achieved. Persistent shallow subretinal fluid was noted in one case, which was resolved progressively during the follow-up. The surgery significantly improved the BCVAs (from 1.8 logarithm of the minimum angle of resolution units to 0.70 logarithm of the minimum angle of resolution units (P < 0.001) at the last visit after surgery. 87% (26/30) eyes restored foveolar architecture. Ellipsoid zone recovery within foveola was found in 77% (23/30) of eyes.

Conclusions:

A vitrectomy combined with C-Shaped inverted temporal ILM flap is effective for closing MHs, reattaching the retina, restoring foveola architecture and significantly improves the postoperative BCVA in MHRD patients. This technique is readily feasible with a less steep learning curve. We thus propose a concept of “presumed” Müller cell cone repair in the surgery of MHRD.

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