INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP

Giamberto Casini, Marco Mura, Michele Figus, Pasquale Loiudice, Enrico Peiretti, Stefano de Cillà, Taiusha Fuentes, Francesco Nasini

Research output: Contribution to journalArticle

Abstract

PURPOSE:: To determine whether surgical manipulation steps of the internal limiting membrane (ILM) flap, such as ILM trimmed, ILM tuck inside the hole, ILM massage, are mandatory to obtain satisfactory outcomes for the repair of large stage IV idiopathic macular hole using the inverted ILM flap technique. METHODS:: In this interventional comparative prospective single-masked study, 81 eyes were randomized into 2 treatments groups. In Group 1 (41 eyes), the classic inverted ILM flap technique was performed. In Group 2 (40 eyes), a modified procedure was used: after ILM peeling, no extra flap manipulation was performed. The macular hole was covered by the inverted ILM flap because of the air pressure at the time of the fluid–air exchange. RESULTS:: At 12 months, macular hole closure was observed in 40 eyes (97.6%) in Group 1 and in 39 eyes in Group 2 (97.5%). U-shape closure rate, ellipsoid zone defects, and external limiting membrane defects were similar in both groups. The results indicate no statistical difference in anatomical and functional success between both groups. CONCLUSION:: The macular hole closure rate, improved visual acuity, and no extra complications indicate noninferiority of the modified inverted ILM technique. Internal limiting membrane finishing, tucking, and massage may not be required to obtain surgical success.

Original languageEnglish (US)
JournalRetina
DOIs
StateAccepted/In press - Jan 26 2017

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Retinal Perforations
Membranes
Massage
Single-Blind Method
Air Pressure
Visual Acuity

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Casini, G., Mura, M., Figus, M., Loiudice, P., Peiretti, E., de Cillà, S., ... Nasini, F. (Accepted/In press). INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP. Retina. https://doi.org/10.1097/IAE.0000000000001470

INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP. / Casini, Giamberto; Mura, Marco; Figus, Michele; Loiudice, Pasquale; Peiretti, Enrico; de Cillà, Stefano; Fuentes, Taiusha; Nasini, Francesco.

In: Retina, 26.01.2017.

Research output: Contribution to journalArticle

Casini, Giamberto ; Mura, Marco ; Figus, Michele ; Loiudice, Pasquale ; Peiretti, Enrico ; de Cillà, Stefano ; Fuentes, Taiusha ; Nasini, Francesco. / INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP. In: Retina. 2017.
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abstract = "PURPOSE:: To determine whether surgical manipulation steps of the internal limiting membrane (ILM) flap, such as ILM trimmed, ILM tuck inside the hole, ILM massage, are mandatory to obtain satisfactory outcomes for the repair of large stage IV idiopathic macular hole using the inverted ILM flap technique. METHODS:: In this interventional comparative prospective single-masked study, 81 eyes were randomized into 2 treatments groups. In Group 1 (41 eyes), the classic inverted ILM flap technique was performed. In Group 2 (40 eyes), a modified procedure was used: after ILM peeling, no extra flap manipulation was performed. The macular hole was covered by the inverted ILM flap because of the air pressure at the time of the fluid–air exchange. RESULTS:: At 12 months, macular hole closure was observed in 40 eyes (97.6{\%}) in Group 1 and in 39 eyes in Group 2 (97.5{\%}). U-shape closure rate, ellipsoid zone defects, and external limiting membrane defects were similar in both groups. The results indicate no statistical difference in anatomical and functional success between both groups. CONCLUSION:: The macular hole closure rate, improved visual acuity, and no extra complications indicate noninferiority of the modified inverted ILM technique. Internal limiting membrane finishing, tucking, and massage may not be required to obtain surgical success.",
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