First Author: T.Sakurai JAPAN
Co Author(s): G. Takaoka T. Kinoshita T. Mano 0 0 0 0 0 0 0 0 0
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Pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flap technique has been known as an effective surgery for old macular hole (MH). We performed PPV with a modified technique, which the ILM remnant along the half margin of the MH was used as an inverted flap (Hemi-Inverted method), and investigated the usability of this technique at one-year follow-up.
retro spctive resarch
Nine eyes of 9 patients underwent PPV with Hemi-Inverted ILM flap technique for MH (maximum diameter: ≧800μm, minimum diameter: ≧450μm) between October 2011 and April 2012. In all cases, preoperative decimal visual acuity (VA) was 0.3 or below. At one-year postoperatively, VA and optical coherence tomography (OCT) was performed and assessed in all cases.
Successful MH closure was achieved in all cases. The mean maximum diameter of MH was 1012±89.4μm and the mean minimum diameter was 554±102.7μm. The mean preoperative and postoperative logMAR VA was 0.85±0.33 and 0.33±0.21, respectively, which showed significant improvement (Paired t test, p=0.003). Morphological improvement of external limiting membrane, photoreceptor inner segment and IS/OS line, however, could be observed only in 2 of 9 cases.
PPV with Hemi-Inverted ILM flap technique for MH closure was useful. However, morphological improvement of retinal outer segment was not sufficient in most of the cases, besides, satisfied functional improvement could not be achieved.