Abstract
Purpose :
To compare clinical characteristics and closure rates of patients undergoing either vitrectomy with inverted internal limiting membrane (ILM) flap or vitrectomy with standard ILM peeling and removal for macular hole by a single surgeon at a single center.
Methods :
A retrospective review was performed of all patients undergoing macular hole repair by a single surgeon at a single center. Sixty-four patients were identified as having undergone either vitrectomy with inverted ILM flap technique or vitrectomy with standard ILM peeling and removal between 2013 and 2017. The standard ILM peel technique was utilized prior to 2015 and the inverted ILM flap technique was performed during and after 2015. Clinical characteristics, including demographic data, phakia status, presence of myopia or degeneration associated with MH, ocular history, MH size, retinal thickness, IOP at presentation, type of gas used, gauge of surgery, and best corrected visual acuity was recorded pre-operatively, at 1 month postoperative, and every 3 months for a total of 2 years. Preplanned secondary analysis stratifying the groups based on size of macular hole was also performed. Patients with complicating factors such as macular hole retinal detachments or prior surgical repair of the macular hole were excluded.
Results :
Twenty-four patients (37.5%) underwent vitrectomy with standard ILM peeling and removal while 40 patients (62.5%) underwent vitrectomy with inverted ILM flap. In the standard peel group, the average age was 67.3 years (SD of 4.2 years), with 15 female (62.5%), and with a majority of patients being Asian and Caucasian. In the inverted flap group, the average age was 66.3 years of age with SD of 4.7), twenty-seven female, and with a majority of Asian and Caucasian patients. Closure rates in the ILM peel group at 1 month was 83% (N=23) and in the inverted ILM flap group was 90%. (N=36). Using chi-squared analysis the p-value of 0.42. Reopening or requiring additional surgery was 10% (N =2) in the standard peel group and 7.5% (N =3) in the inverted flap group.
Conclusions :
Both techniques demonstrated high rates of macular hole closure, similar to published results. In this cohort of patients, macular hole closure rates were slightly higher in the group that underwent vitrectomy with inverted ILM flap technique, however it was not statistically significant.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.