Comparison of the combined internal limiting membrane peeling and macular detachment technique with the internal limiting membrane peeling and inverted flap surgical technique in the treatment of large macular holes
Khodayar Golabchi1 *, Mohammadreza Akhlaghi1 , Heshmatollah Ghanbari1
- Isfahan University of Medical Sciences
Abstract: To contrast the functional and anatomical results of using Macular Detachment with radial retinotomies and subretinal BSS injection, combined with inverted Internal Limiting Membrane (ILM) peeling and flap, (MD+iILM peeling) with the surgical approach of only ILM peeling and inverted flap (iILM peeling) for treating large, first-time Macular Holes (MHs).
Methods: After receiving ethical approvals, this clinical trial was conducted on patients who had a macular size larger than 400 microns and had not received treatment before. Patients were randomy assigned to two groups: pars plana vitrectomy (PPV) with ILM peeling and inverted flap (iILM) technique and PPV with combined iILM and macular detachment (MD) technique. Visual acuity and success rate of MH closure were compared between the two groups before and after the surgeries.
Results: 16 patients were randomly assigned to the iILM and 14 patients to the MD+iILM groups. The success rate of MH closure in iILM and MD+iILM groups were respectively 0.87% and 100% but it was not significant. The visual acuity was improved in both groups significantly on basis LogMAR ( from 0.994 to 0.837 in iILM group and from 1.093 to .714 in MD+iILM group, P value< 0.05). there was no major complications during or after the surgery, aside from the development of some cataracts.
Conclusion: The new MD+iILM surgical method was as successful as the previous iILM surgical method which was considered the gold standard to treat MHs. This surgical approach with a high anatomical and functional success rate can be considered as a good treatment method in large macular holes surgeries.
