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Retinal re‐modelling following ILM flap technique for FTMH
Author(s) -
Stappler T.,
Hussain R.,
Heimann H.,
Wong D.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.02714
Subject(s) - macular hole , medicine , retinal , ophthalmology , visual acuity , surgery , vitrectomy
Surgical challenges remain for large macular holes, long standing holes as well as repeat surgery for non‐closed macular holes. For these indications the success rate drops dramatically. The role of ILM flaps in anatomical and visual rehabilitation remains controversial. Method OCT ‐based longitudinal cohort study of ILM flaps mapping OCT changes over time. Inclusion criteria were macular holes larger than 500 μ m. Primary outcome measure: anatomical macular hole closure. Further outcome measures: OCT ‐based longitudinal assessment of ELM as well as ellipsoid layer. Results We present a case series of (n = 33) patients who underwent ILM flap surgery between June 2015‐Jun 2016. All holes 33/33 have been anatomically closed. OCT 's were recorded and anatomical and functional changes mapped. 23/33 regained a distinguishable ELM by 3/12 (70%) and 22/33 regained the ellipsoid layer by 3/12 (67%). Follow up was between 4‐6/12. Discussion The ILM flap technique for FTMH clearly helps hole ‘closure’ since all holes showed anatomical closure. The regeneration of outer retinal layers seems to help visual outcome. Yet the significance of the amorphous flap tissue remains undetermined and the study cannot yet predict postoperative vision.