Kumari Archana, Agarwal Lalit, Agrawal Nisha, Sahu Sabin, Prasad Indranath, Pradhan Deepti
Biratnagar Eye Hospital, Biratnagar, Nepal.
Taparia Eye Care, Biratnagar, Nepal.
GMS Ophthalmol Cases. 2020 May 28;10:Doc27. doi: 10.3205/oc000154. eCollection 2020.
Various modifications of surgical techniques and surgical adjuncts are adopted with standard pars plana vitrectomy (PPV) to improve the outcome of traumatic macular hole (TMH) surgeries. We describe a successful closure of a chronic large TMH of three years duration with inverted temporal internal limiting membrane (ILM) flap technique. A 36-year-old male patient had an optical coherence tomography (OCT) documented chronic macular hole (MH) for three years following blunt trauma. Fundus examination also showed choroidal rupture scar temporal to fovea. The minimum MH diameter was 769 µ and the basal diameter 1431 µ in OCT. Standard PPV with inverted temporal ILM flap and gas tamponade was done. The postoperative period was uneventful. The best corrected visual acuity improved from 6/60 preoperatively to 6/18 six months postoperatively, and OCT showed a closed MH with anatomical type 1 closure. This case highlights that the inverted temporal ILM flap technique is a safe and effective technique for patients with even chronic and large TMH.
在标准的玻璃体切割术（PPV）基础上，人们采用了各种手术技术改良和手术辅助手段，以改善外伤性黄斑裂孔（TMH）手术的效果。我们描述了一例采用颞侧内界膜（ILM）翻转瓣技术成功闭合持续三年的慢性大尺寸TMH的病例。一名36岁男性患者在钝挫伤后经光学相干断层扫描（OCT）记录有慢性黄斑裂孔（MH）三年。眼底检查还显示在黄斑中心凹颞侧有脉络膜破裂瘢痕。在OCT中，最小的MH直径为769µ，基底直径为1431µ。实施了标准的PPV联合颞侧ILM翻转瓣和气体填充术。术后过程顺利。最佳矫正视力从术前的6/60提高到术后六个月的6/18，并且OCT显示MH闭合，为解剖学上的1型闭合。该病例突出表明，对于即使是慢性和大尺寸的TMH患者，颞侧ILM翻转瓣技术也是一种安全有效的技术。
