Efficacy of Inverted Internal Limiting Membrane Flap Technique for the Treatment of Macular Hole in High Myopia

Vitrectomy with Internal Limiting Membrane Repositioning and Autologous Blood for Macular Hole Retinal Detachment in Highly Myopic Eyes

“…This technique also has been applied in a case series of highly myopic eyes to repair an MH with or without RD. 25 However, blood components have been use to facilitate the hole closure in MH surgery for a long period. 26e29 Apart from the cell components such as platelets, various factors in the serum have been demonstrated to facilitate the wound-healing process in the human body.…”

“…The ILM at the margin of the hole was connected as previously described. 24,25 After the ILM was lifted, the ILM flap was inverted and used to fill the entire MH by forceps. In a previously published study, the investigator used only a layer of the ILM flap to cover the MH.…”

“…24,25 In addition, blood from the patient long has been applied in vitreoretinal surgeries, and blood components long have been used to improve the hole closure rate for MH. 26e29 The purpose of this study was to determine the efficacy of a modified combination therapy, that is, a vitrectomy with inverted ILM repositioning (ILMR) combined with autologous blood clot (ABC) and gas tamponade in a prone position for 1 day, to treat MHRD in highly myopic eyes.…”

Multiple Free Internal Limiting Membrane Flap Insertion in the Treatment of Macular Hole-Associated Retinal Detachment in High Myopia

“…Several techniques have recently been proposed to treat MHs with RD in high myopia to improve the hole closure rate, such as inverted epiretinal ILM flap [3], inverted ILM flap insertion with or without blood coverage of the hole, or single-layer inverted flap [4-7]. Although the reported MH closure rate is very high, there are 2 major difficulties with these techniques that leave rooms for improvement.…”

“…Several methods have been proposed to increase the MH closure rate after vitrectomy with internal limiting membrane (ILM) peeling, such as inverted epiretinal ILM flap [3], inverted ILM flap insertion [4] with or without blood coverage of the hole [5], temporal, or superior single-layer inverted ILM flap [6, 7]. Making an epiretinal flap to cover the hole or creating ILM flaps around the MH to insert into the hole may be technically demanding, and ILM flaps with an appropriate size and shape cannot always be created in a staphylomatous eye with epiretinal membrane and RD.…”