Outcomes of Macular Hole Surgery with Short-Duration Positioning in Highly Myopic Eyes

Conart, Jean‐Baptiste; Selton, J.; Hubert, I.; Tréchot, F; Adssi, H. El; Creuzot‐Garcher, Catherine; Berrod, J.–P.

doi:10.1016/j.ophtha.2013.12.005

Cited by 19 publications

(19 citation statements)

References 40 publications

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“…2. Larger radius of the hole and more holes correlate with the higher myopia, which is in accordance with the investigation results that the most common macular change in highly myopic eyes is macular holes(micron scale) [25][26][27][28][29][30] , according to this model, the hole in the eye causes myopia but not myopia causes the hole.…”

Section: Verification Of This Modelsupporting

confidence: 91%

Visual Light Leak in High-Frequency Electromagnetic Radiation Hole: A Photon-Electron Theory for Living Tissue for Explaining Myopia

Lee¹

2019

Preprint

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The exact etiology of myopia remains elusive. The author proposes the particle property of photon in living tissue and the photon-electron theory in living tissue, if the frequency of the photon beyond the threshold, the photon has enough energy to strike the electron away and forms a hole of a diameter in photon diameter scale in living tissue include the eye.The visual light which passes through the radiation hole in the eye cannot be refracted on the macula. Longer time of high-frequency electromagnetic radiation will cause more holes and a larger radius of holes, which lead to high myopia, this is in accordance with the investigation results that high myopic eyes have macular holes (micron scale). According to the particle property of the photon model, the eye elongated by the striking of high-frequency photons.

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Section: Verification Of This Modelsupporting

confidence: 91%

Visual Light Leak in High-Frequency Electromagnetic Radiation Hole: A Photon-Electron Theory for Living Tissue for Explaining Myopia

Lee¹

2019

Preprint

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“…[ 15 ] Large MHs (minimum diameter >400 μm), however, usually had an increased risk of surgical failure, and the closure rate of MHs with high myopia, reported between 83% and 87%, appeared to be lower than the idiopathic forms. [ 16 17 ] In addition, about 19–39% of the so-called anatomically closed large MHs were actually flat-open. [ 6 7 8 ] This is not hard to understand considering that the traditional ILM peeling might only release the tangential traction, but cannot compensate for tissue shortening in large MHs.…”

Section: Discussionmentioning

confidence: 99%

Inverted Internal Limiting Membrane Flap Technique for Repair of Large Macular Holes

Chen

Zhao

et al. 2016

Chinese Medical Journal

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Background:Inverted internal limiting membrane (ILM) flap technique has recently been reported in a limited number of studies as an effective surgical technique for the management of large macular holes (MHs) with fair MH closure rates as well as gains in visual acuity. In the current study, longitudinal changes in multi-focal electroretinogram (mfERG) responses, best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated in eyes with large MHs managed by this technique.Methods:A prospective noncontrolled interventional study of eight patients (eight eyes) with large MHs (minimum diameter >400 μm) was conducted. All MHs were treated with pars plana vitrectomy and indocyanine green-assisted inverted ILM flap technique. SD-OCT images were used to assess the anatomical outcomes of surgery while BCVA and mfERG were used to evaluate the functional outcomes during a 3-month follow-up.Results:All patients underwent successful intended manipulation and translocation of the ILM flap without flap dislocation and achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in all cases as early as 1 month after surgery. Functionally, as compared to baseline, all patients showed improvements in BCVA and all but one in mfERG response during follow-up. However, Pearson's test revealed no significant correlations between BCVA and mfERG responses of the fovea and of the macular area at each evaluation time point.Conclusions:Inverted ILM flap technique appeares to be a safe and effective approach for the management of large idiopathic MHs with favorable short-term anatomical and functional results. Postoperative reconstruction of the microstructure generally shows good consistency with improvements in both BCVA and mfERG response, of which the latter might be a supplement for the former in postoperative functional follow-up.

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“…Recent comparative studies reported similar anatomic success rates in face-down positioning and non-supine positioning and comparing long-term and short-term positioning after macular hole surgery [33–37]. Some authors highlight a possible role of strict head position in myopic eyes and in larger holes [35, 38]. A short period of prone position may in the same time promote successful hole closure and reduce patient discomfort as well.…”

Section: Discussionmentioning

confidence: 99%

Sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) tamponade and short term face-down position for macular hole repair: a randomized prospective study

et al. 2016

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BackgroundTo compare early visual and anatomical outcomes after either sulfur hexafluoride (SF6) or perfluoropropane (C3F8) tamponade for macular hole repair.Methods147 eyes affected by primary full-thickness macular hole underwent pars plana vitrectomy with dye assisted removal of the internal limiting membrane and gas tamponade. Prone position was prescribed for 48 h after surgery. All patients were divided into 3 groups depending on the size of the hole: small (<250 µm), medium (>250–<400 µm) or large (>400 µm). Eyes within the same group randomly received either SF6 (70 eyes) or C3F8 (77 eyes). A complete ophthalmic evaluation, including best corrected visual acuity and anatomic status of the macular holes, was conducted preoperatively, at 1 week and 1 month after surgery. Macular hole volume was calculated using optical coherence tomography scans. The Wilcoxon Signed Ranks Test, the Mann–Whitney Test, the Spearman’s rank-order correlation coefficient and the study of variance for repeated measures were used for statistical analysis.ResultsMean best-corrected visual acuity improved from 0.92 logMAR to 0.28 logMAR (P < 0.001). A reduction of the dimensions of macular holes was observed in all cases, with a total repair of 90 % (63/70 eyes) in the SF6 group and 91 % in the C3F8 group (70/77 eyes). There was a negative correlation between the initial minor diameter, the volume of the hole and the rate of anatomic success.ConclusionsShort-term anatomical and visual outcomes were similar in eyes treated with either SF6 or C3F8, independently of the stage of the macular hole. The initial volume and the minor diameter of the hole may be considered as valid tools for predicting surgical success. Age and gender did not appear to have influenced the prognosis.

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Outcomes of Macular Hole Surgery with Short-Duration Positioning in Highly Myopic Eyes

Cited by 19 publications

References 40 publications

Visual Light Leak in High-Frequency Electromagnetic Radiation Hole: A Photon-Electron Theory for Living Tissue for Explaining Myopia

Visual Light Leak in High-Frequency Electromagnetic Radiation Hole: A Photon-Electron Theory for Living Tissue for Explaining Myopia

Inverted Internal Limiting Membrane Flap Technique for Repair of Large Macular Holes

Sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) tamponade and short term face-down position for macular hole repair: a randomized prospective study

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