Abou Shousha Mohsen Ahmed
From the Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt.
Medicine (Baltimore). 2016 Jan;95(3):e2523. doi: 10.1097/MD.0000000000002523.
The aim of the study was to assess the role of inverted internal limiting membrane flap as a treatment option for large traumatic macular holes.This is a prospective noncomparative study in which 12 eyes with large traumatic macular holes (basal diameter of 1300-2800 μm) since 3 to 6 months were subjected to standard 23-gauge vitrectomy with removal of the posterior hyaloid, brilliant blue G (BBG)-assisted internal limiting membrane peeling in a circular fashion keeping it attached to the edge of the hole to create a flap. At the end of the surgery, air fluid exchange was done with inversion of the internal limiting membrane flap inside the macular hole using the soft tipped cannula and sulfur hexafluoride 20% as tamponade. The main follow-up measures are the best corrected visual acuity and the optical coherence tomography for 6 to 9 months.All the included eyes had a closed hole from the first week postoperative and along the follow-up period (6-9 months). The best corrected visual acuity improved from 20/2000 to 20/200 with a median of 20/400 preoperatively to 20/400 to 20/50 with a median of 20/100 at the end of follow-up period.Inverted internal limiting membrane flap is a good adjuvant to standard vitrectomy in the management of large traumatic macular holes that led to the 100% closure rate and improvement of best corrected visual acuity.
本研究的目的是评估倒置内界膜瓣作为治疗大型外伤性黄斑裂孔的一种选择的作用。这是一项前瞻性非对照研究，12只患有大型外伤性黄斑裂孔（基底直径为1300 - 2800μm）且病程3至6个月的眼睛接受了标准的23G玻璃体切除术，切除后玻璃体，采用亮蓝G（BBG）辅助以环形方式进行内界膜剥除，使其附着于裂孔边缘以形成一个瓣。手术结束时，使用软头套管将内界膜瓣倒置在黄斑裂孔内，并使用20%的六氟化硫作为填塞物进行气液交换。主要的随访指标是最佳矫正视力和6至9个月的光学相干断层扫描。所有纳入的眼睛在术后第一周及整个随访期（6 - 9个月）裂孔均已闭合。最佳矫正视力从术前中位数20/2000提高到20/200，术前为20/400，随访结束时为20/400至20/50，中位数为20/100。倒置内界膜瓣是标准玻璃体切除术治疗大型外伤性黄斑裂孔的良好辅助方法，可实现100%的闭合率并改善最佳矫正视力。
