Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience

Emilia Michalewicz, David Kuerten, Yassin Djalali-Talab, Babac Mazinani, Peter Walter, Antonis Koutsonas Department of Ophthalmology, RWTH Aachen University, Aachen, GermanyCorrespondence: Emilia Michalewicz, Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, Aachen, 52074, Germany...

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Main Authors: Michalewicz E, Kuerten D, Djalali-Talab Y, Mazinani B, Walter P, Koutsonas A
Format: Article
Language:English
Published: Dove Medical Press 2023-06-01
Series:Clinical Ophthalmology
Subjects:
Online Access:https://www.dovepress.com/short-term-clinical-results-after-ilm-removal-and-inverted-ilm-flap-fo-peer-reviewed-fulltext-article-OPTH
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author Michalewicz E
Kuerten D
Djalali-Talab Y
Mazinani B
Walter P
Koutsonas A
author_facet Michalewicz E
Kuerten D
Djalali-Talab Y
Mazinani B
Walter P
Koutsonas A
author_sort Michalewicz E
collection DOAJ
description Emilia Michalewicz, David Kuerten, Yassin Djalali-Talab, Babac Mazinani, Peter Walter, Antonis Koutsonas Department of Ophthalmology, RWTH Aachen University, Aachen, GermanyCorrespondence: Emilia Michalewicz, Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, Aachen, 52074, Germany, Tel +49 241 80 35147, Fax +49 241 80-82408, Email emilia.michalewicz@gmail.comPurpose: To compare results after ILM peeling and ILM inverted flap technique utilized the repair of full thickness macular holes, irrespective of their size.Patients and Methods: Pre- and postoperative data of 109 patients who suffered from a full thickness macular hole were retrospectively analyzed. Forty-eight patients were treated with an inverted ILM flap technique, 61 patients were treated with ILM peeling. All patients received a gas tamponade. The primary endpoint was macular hole closure as demonstrated by OCT scanning. Secondary endpoints were best corrected visual acuity and clinical complication rates.Results: For small and medium-sized macular holes the closure rates in the ILM flap technique group were 100% and 94%, respectively. For ILM peeling, the closure rate was identical (95%). For large macular holes, the closure rate was 100% in the flap versus 50% in the ILM peeling group, but visual acuity improved in both groups (ILM flap p=0.001, ILM peeling p=0.002). In both treatment groups, larger holes were associated with a reduced final visual outcome. For medium-sized macular holes, visual acuity significantly improved only in the ILM peeling group. Both techniques were associated with minimal and comparable side effects.Conclusion: In our limited series, the inverted ILM flap technique for repair of macular holes demonstrated a high closure rate. For large MHs, we saw a trend towards a better closure rate in the flap technique compared to ILM peel only. However, final visual acuity showed no significant difference between the groups. Clinical results and complications appeared to be comparable in both groups.Keywords: ILM peeling, flap technique, pars plana vitrectomy
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spelling doaj.art-84f4a4f2905c4c98b1594b12e8be8d292023-06-06T19:22:44ZengDove Medical PressClinical Ophthalmology1177-54832023-06-01Volume 171605161884253Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective ExperienceMichalewicz EKuerten DDjalali-Talab YMazinani BWalter PKoutsonas AEmilia Michalewicz, David Kuerten, Yassin Djalali-Talab, Babac Mazinani, Peter Walter, Antonis Koutsonas Department of Ophthalmology, RWTH Aachen University, Aachen, GermanyCorrespondence: Emilia Michalewicz, Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, Aachen, 52074, Germany, Tel +49 241 80 35147, Fax +49 241 80-82408, Email emilia.michalewicz@gmail.comPurpose: To compare results after ILM peeling and ILM inverted flap technique utilized the repair of full thickness macular holes, irrespective of their size.Patients and Methods: Pre- and postoperative data of 109 patients who suffered from a full thickness macular hole were retrospectively analyzed. Forty-eight patients were treated with an inverted ILM flap technique, 61 patients were treated with ILM peeling. All patients received a gas tamponade. The primary endpoint was macular hole closure as demonstrated by OCT scanning. Secondary endpoints were best corrected visual acuity and clinical complication rates.Results: For small and medium-sized macular holes the closure rates in the ILM flap technique group were 100% and 94%, respectively. For ILM peeling, the closure rate was identical (95%). For large macular holes, the closure rate was 100% in the flap versus 50% in the ILM peeling group, but visual acuity improved in both groups (ILM flap p=0.001, ILM peeling p=0.002). In both treatment groups, larger holes were associated with a reduced final visual outcome. For medium-sized macular holes, visual acuity significantly improved only in the ILM peeling group. Both techniques were associated with minimal and comparable side effects.Conclusion: In our limited series, the inverted ILM flap technique for repair of macular holes demonstrated a high closure rate. For large MHs, we saw a trend towards a better closure rate in the flap technique compared to ILM peel only. However, final visual acuity showed no significant difference between the groups. Clinical results and complications appeared to be comparable in both groups.Keywords: ILM peeling, flap technique, pars plana vitrectomyhttps://www.dovepress.com/short-term-clinical-results-after-ilm-removal-and-inverted-ilm-flap-fo-peer-reviewed-fulltext-article-OPTHilm peelingflap techniquepars plana vitrectomy
spellingShingle Michalewicz E
Kuerten D
Djalali-Talab Y
Mazinani B
Walter P
Koutsonas A
Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
Clinical Ophthalmology
ilm peeling
flap technique
pars plana vitrectomy
title Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
title_full Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
title_fullStr Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
title_full_unstemmed Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
title_short Short-Term Clinical Results After ILM Removal and Inverted ILM Flap for Macular Hole Repair – A Single-Center Retrospective Experience
title_sort short term clinical results after ilm removal and inverted ilm flap for macular hole repair ndash a single center retrospective experience
topic ilm peeling
flap technique
pars plana vitrectomy
url https://www.dovepress.com/short-term-clinical-results-after-ilm-removal-and-inverted-ilm-flap-fo-peer-reviewed-fulltext-article-OPTH
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