Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, Spain.
Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2022 Sep;97(9):514-520. doi: 10.1016/j.oftale.2022.06.002. Epub 2022 Jul 1.
To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling.
Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups.
There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p=0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0.62).
ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.
评估改良的上方倒置内界膜(ILM)瓣技术在孔源性视网膜脱离合并黄斑裂孔中的疗效,与 ILM 撕除相比,该技术在视网膜再附着、黄斑裂孔闭合和外层视网膜恢复方面的效果。
回顾性系列病例研究,纳入了 10 例需要行玻璃体切除术治疗黄斑裂孔伴视网膜脱离的患者,随访时间超过 12 个月。回顾性收集病历数据,并将患者分为上方倒置瓣组(5 例)和 ILM 撕除组(5 例)。比较两组患者手术前后最佳矫正视力(BCVA)、视网膜复位、黄斑裂孔闭合率和外层视网膜恢复情况。
两组患者手术前后 BCVA均有显著改善,术后 12 个月两组间无差异(p=0.9)。倒置瓣组黄斑裂孔闭合率为 100%,ILM 撕除组为 80%,两组间无显著差异。两组患者视网膜均完全复位。仅 2 例(40%)上方倒置瓣组患者有外层视网膜恢复,而 ILM 撕除组无患者有此情况(p=0.62)。
ILM 撕除和上方倒置瓣技术对治疗近视性孔源性视网膜脱离合并黄斑裂孔有效。