Mete Maurizio, Alfano Alessandro, Guerriero Massimo, Prigione Guido, Sartore Mauro, Polito Antonio, Pertile Grazia
*Department of Ophthalmology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy; and †Department of Computer Science, University of Verona, Verona, Italy.
Retina. 2017 Oct;37(10):1923-1930. doi: 10.1097/IAE.0000000000001446.
To compare the results of vitrectomy with complete internal limiting membrane (ILM) removal and inverted ILM flap in the treatment of myopic macular hole (MMH).
Seventy eyes of 68 patients with MMH undergone pars-plana vitrectomy (PPV) with either complete ILM removal (n = 36, Group 1) or inverted ILM flap technique (n = 34, Group 2) were included in the study. Outcomes measured were the rate of MMH closure assessed by optical coherence tomography (OCT) and visual acuity (BCVA) at six months.
Closure of MMH was achieved in 22 cases of Group 1 (61%) and in 32 cases of Group 2 (94%). Surgical failure was reported in 14 cases of Group 1 (39%) and in one case of Group 2 (3%). Average best-corrected visual acuity (BCVA) changed from 0.60 to 0.58 in Group 1 (P = 0.329) and from 0.70 to 0.39 in Group 2 (P < 0.01). Logistic regression analysis showed that inverted ILM flap technique was associated with 22 times higher probability of anatomic success, regardless of the MMH diameter.
Inverted ILM flap should be preferred to complete ILM removal for the treatment of MMH. The outcomes reported with this technique were better than any other technique described until now.
比较玻璃体切割术联合完全剥除内界膜（ILM）与反转ILM瓣治疗高度近视黄斑裂孔（MMH）的效果。
本研究纳入了68例患有MMH的患者的70只眼，这些患者均接受了玻璃体切除术（PPV），其中36只眼采用完全剥除ILM（第1组），34只眼采用反转ILM瓣技术（第2组）。测量的结果包括通过光学相干断层扫描（OCT）评估的MMH闭合率以及6个月时的视力（最佳矫正视力，BCVA）。
第1组22例（61%）MMH闭合，第2组32例（94%）MMH闭合。第1组14例（39%）手术失败，第2组1例（3%）手术失败。第1组平均最佳矫正视力（BCVA）从0.60变为0.58（P = 0.329），第2组从0.70变为0.39（P < 0.01）。逻辑回归分析表明，无论MMH直径如何，反转ILM瓣技术使解剖学成功的概率提高22倍。
治疗MMH时，反转ILM瓣技术优于完全剥除ILM。该技术报告的结果优于迄今为止描述的任何其他技术。
