&lt;p&gt;Inverted internal limiting membrane (ILM) flap technique for macular hole closure: patient selection and special considerations&lt;/p&gt;

Shroff, Daraius; Gupta, Priyanka; Atri, Neelam; Gupta, Charu; Shroff, Cyrus

doi:10.2147/opth.s163089

Cited by 15 publications

(13 citation statements)

References 46 publications

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“…This has been seen with the introduction of the inverted ILM flap technique, which has demonstrated higher success rates for closure of large MH than techniques that use ILM peeling alone. 8 The precise mechanism of the inverted ILM flap technique is not yet clearly understood. It is possible that the flap acts as a scaffold for glial cell proliferation leading to closure of the hole.…”

Section: Discussionmentioning

confidence: 99%

Inverted Internal Limiting Membrane Flap Technique Without Postoperative Face-Down Positioning for Macular Hole Repair

Ruparelia

Tuli

Park

et al. 2022

Retina

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Section: Discussionmentioning

confidence: 99%

Inverted Internal Limiting Membrane Flap Technique Without Postoperative Face-Down Positioning for Macular Hole Repair

Ruparelia

Tuli

Park

et al. 2022

Retina

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“…As evident by various studies, preoperative hole size was the only predictor of postoperative VA, which is inversely proportional to VA gain. [ 20 21 22 23 ] A retrospective study on 50 eyes showed a decrease in VA by 10% for every 26-mm increase in the BHD. [ 14 ] However, in our study, despite including extremes of BD, ranging from 464 to 9778 microns, no such trend was seen and the odds of VA change associated with BD were negligible.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative optical coherence tomography predictors: Do they hold any relevance in the era of inverted internal limiting membrane flap in large macular holes?

Narnaware

Bawankule²,

Bansal

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To study the relevance of preoperative OCT predictors in large macular holes (MH) treated using the inverted ILM peel technique. Methods: Prospective study of 95 patients undergoing vitrectomy for large MH between January 2019 and December 2020 was performed by dividing the patients into groups depending on various quantitative parameters and indices of MH such as base diameter (BD), hole form factor (HFF), macular hole index (MHI), diameter hole index (DHI), and tractional hole index (THI) by using parameters such as minimal hole diameter, hole height, nasal and temporal arm lengths. Depending upon the duration of symptoms, patients were divided into three groups: <3 months, 3–6 months, and >6 months. Anatomical success rate, type of closure, and postoperative vision gain were analyzed in relation to the abovementioned diameters, indices, and duration to see if any significance existed. Results: The mean age of patients included in the study was 60.48 ± 13.88 years, with female preponderance (males: females = 37:58). Change in logMAR was statistically significant individually with all studied parameters ( P < 0.0001) without influence of size of hole and other indices. BD and DHI levels showed significant association with type of closure as indicated by P values of 0.017 and 0.048, respectively. Duration of symptoms showed no significance in terms of anatomical and functional success. Conclusion: OCT predictors of MH success seem to have lost relevance with inverted flap surgeries as 100% anatomical success is achieved with this technique, with 95.78% (91/95) achieving type 1 closure with statistically significant equivalent functional gain across the indices with no effect of duration of symptoms.

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“…2 ] superior to conventional ILM peeling. [ 24 ] Michalowski et al . [ 12 ] found anatomical closure rate was higher in inverted ILM flap technique (98%) compared to conventional ILM peeling (88%).…”

Section: Discussionmentioning

confidence: 99%

Multilayered inverted internal limiting membrane flap technique versus standard internal limiting membrane peeling for large macular holes: A comparative study

Agrawal

Jindal

Dhakad

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To evaluate the outcome of vitrectomy with multilayered inverted internal limiting membrane flap technique (ML-IILM) versus vitrectomy with standard ILM peeling for large macular holes in terms of visual acuity and anatomical closure. Methods: A hospital-based, prospective, randomized, interventional study was conducted during three calendar years with a total 150 eyes (75 in each group) in two groups—vitrectomy with ILM peeling (Group A) and vitrectomy with ML-IILM flap technique (Group B) after informed consent of study participants who met the inclusion criteria. Results: The mean minimum and maximum diameter of macular hole did not differ statistically in both the groups. Macular hole index had no significant difference between both groups Pre-operative visual acuity was not statistically significantly different between the two groups. During follow-up, best corrected visual acuity (BCVA) at 1 month, 3 months, 6 months, and 12 months was significantly better in Group B (0.12 ± 0.07 at 1 month, 0.14 ± 0.10 at 3 months, 0.18 ± 0.11 at 6 months, and 0.19 ± 0.12 at 12 months) compared to Group A (0.20 ± 0.11 at 1 month, 0.22 ± 0.13 at 3 months, 0.30 ± 0.12 at 6 months, and 0.31 ± 0.14 at 12 months) (P = 0.001 for each). Type 1 anatomical closure (flattening of cuff and opposition of edges of hole) was achieved in 78.66% (59/75) cases in Group A and 93.33% (70/75) cases in Group B (P 0.0016). Conclusion: Vitrectomy with multilayered inverted ILM flap technique had significantly higher anatomical closure and better visual outcome than vitrectomy with standard ILM peeling.

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<p>Inverted internal limiting membrane (ILM) flap technique for macular hole closure: patient selection and special considerations</p>

Cited by 15 publications

References 46 publications

Inverted Internal Limiting Membrane Flap Technique Without Postoperative Face-Down Positioning for Macular Hole Repair

Inverted Internal Limiting Membrane Flap Technique Without Postoperative Face-Down Positioning for Macular Hole Repair

Pre-operative optical coherence tomography predictors: Do they hold any relevance in the era of inverted internal limiting membrane flap in large macular holes?

Multilayered inverted internal limiting membrane flap technique versus standard internal limiting membrane peeling for large macular holes: A comparative study

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