PURPOSE

To analyze the outcomes of using an internal limiting membrane (ILM) flap and the conventional ILM peel technique for small- or medium-sized full-thickness macular hole (FTMH) repair.

DESIGN

Retrospective, interventional case series.

METHODS

Eyes with an FTMH ≤400 µm that underwent vitrectomy with a single-layer inverted ILM flap (flap group, 55 eyes) or an ILM peel (peel group, 62 eyes) were enrolled. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) measurements were obtained preoperatively and at 1, 3, 6, and 12 months postoperatively.

RESULTS

Primary hole closure was achieved in 54 (98%) and 60 (97%) eyes in the flap and peel groups, respectively. The preoperative and postoperative 12-month BCVA values were comparable between the groups but were significantly better in the flap than in the peel group at 1 month (mean ± SD logMAR: 0.83 ± 0.43 vs 1.14 ± 0.50; P = .001), 3 months (0.58 ± 0.33 vs 0.82 ± 0.43; P = .002), and 6 months (0.56 ± 0.32 vs. 0.72 ± 0.48; P = .028). In the flap group, foveal gliosis was less common than in the peel group at 1 month (P = .030), and restored external limiting membrane and interdigitation zone was more common at 3 months (P = .046 and P < .001, respectively).

CONCLUSIONS

The single-layer ILM flap and conventional ILM peel techniques both closed FTMHs and improved vision. ILM flaps were associated with better visual outcomes up to 6 months postoperatively and should be considered in FTMHs ≤400 µm.

中文翻译：

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用于中小型全层黄斑裂孔的单层倒置内部限制膜瓣与常规剥离

目的

分析使用内界膜 (ILM) 皮瓣和传统 ILM 剥离技术进行中小型全层黄斑裂孔 (FTMH) 修复的结果。

设计

回顾性、介入性病例系列。

方法

FTMH ≤400 µm 的眼睛被纳入玻璃体切除术，单层倒置 ILM 皮瓣（皮瓣组，55 只眼）或 ILM 剥离（剥离组，62 只眼）。最佳矫正视力 (BCVA) 和光学相干断层扫描 (OCT) 测量在术前和术后 1、3、6 和 12 个月时获得。

结果

皮瓣组和果皮组分别有 54 只 (98%) 和 60 只 (97%) 只眼实现了初次孔闭合。两组的术前和术后 12 个月 BCVA 值具有可比性，但在 1 个月时，皮瓣组明显优于剥离组（平均值 ± SD logMAR：0.83 ± 0.43 vs 1.14 ± 0.50；P  = .001），3个月（0.58 ± 0.33 对 0.82 ± 0.43；P  = .002）和 6 个月（0.56 ± 0.32 对 0.72 ± 0.48；P  = .028）。皮瓣组在 1 个月时中心凹神经胶质增生的发生率低于剥离组（P  = .030），而在 3 个月时恢复的外界膜和叉指区更为常见（P  = .046 和P < .001，分别）。

结论

单层 ILM 皮瓣和传统 ILM 剥离技术既能闭合 FTMH，又能改善视力。ILM 皮瓣与术后 6 个月更好的视觉结果相关，应在 FTMH ≤400 µm 时考虑。