June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Comparsion of three different ILM surgical techniques for myopic traction maculopathy with lamellar macular hole
Author Affiliations & Notes
  • Qing Shao
    Aier Eye Hospital Group, Changsha, Hubei, China
  • Footnotes
    Commercial Relationships   Qing Shao None
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    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2914. doi:
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      Qing Shao; Comparsion of three different ILM surgical techniques for myopic traction maculopathy with lamellar macular hole. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2914.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To compare the surgical outcomes of pars plana vitrectomy (PPV) with standard internal limiting membrane (ILM) peeling or fovea-sparing ILM peeling (FSIP) or inverted ILM flap (ILMF) techniques for myopic traction maculopathy (MTM) accompanied with lamellar macular hole (LMH).

Methods : This retrospective cohort study enrolled 101 eyes of 98 consecutive patients undergoing PPV with either standard ILM peeling (n = 32) or FSIP (n = 34) or ILMF (n = 35) from July 2017 to March 2020. All patients were follow-up for at least 12 months after surgery. Best-corrected visual acuity (BCVA), time to resolution of schisis or detachment, central foveal thickness (CFT), integrity of ellipsoid zone (EZ) and postoperative complications such as secondary full thickness macular hole (FTMH) were evaluated.

Results : At baseline, there were no significant differences among three groups in terms of age, sex, diopters, axial length, CFT, MTM stage, atrophy maculopathy and BCVA (P > 0.05). At 12 months postoperatively, mean BCVA was significantly improved from 1.14 ± 0.54 to 0.69 ± 0.42 logMAR (t = 10.400, P < 0.001). Mean CFT reduced significantly from 518.7 ± 157.1 to 217.8 ± 66.4 (t = 17.971, P < 0.01). Postoperative BCVA (F = 0.968, P = 0.383) and CFT (F = 1.194, P = 0.307) showed no significant difference among groups. The intact EZ was confirmed in 14 eyes (43.8%) in the standard ILM peeling group, 15 eyes (44.1%) in the FSIP group and 16 eyes (45.7%) in the ILMF group (P = 0.985). None of the eyes in the ILMF group and 5 eyes (14.7 %) in the FSIP and 6 eyes (18.8 %) in the standard ILM peeling group developed postoperative FTMH (P = 0.015). Multivariate linear regression revealed that BCVA at 12 months was corelated with preoperative BCVA (B = 0.384, P < 0.001), atrophy maculopathy (B = 0.131, P = 0.001) and postoperative FTMH formation (B = 0.382, P < 0.001).

Conclusions : Compared to standard ILM peeling or FSIP, ILMF technique revealed a lower risk of postoperative FTMH as well as similar visual improvements for MTM eyes accompanied with LMH. The ILM flap may play a protective role for the incomplete foveal retina.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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