Minimal internal limiting membrane peeling with ILM flap technique for idiopathic macular holes: a preliminary study
Minimal internal limiting membrane peeling with ILM flap technique for idiopathic macular holes: a preliminary study
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ILM瓣技术最小化内界膜剥离治疗特发性黄斑裂孔：初步研究
DOI：
10.1186/s12886-020-01505-x
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发表时间：
2020-06-15
影响因子：
2
通讯作者：
Xie, Ping
中科院分区：
文献类型：
--
作者：
Hu, Zizhong;Qian, Huiming;Xie, Ping
背景内界膜（internal limiting membrane，ILM）剥除可增加特发性黄斑裂孔（idiopathic macular hole，IMH）的闭合率，但可引起视网膜内层凹陷。本研究介绍一种最小限度剥离内眦膜的方法，并与内眦膜皮瓣，以确保IMH closed.Methods12例连续的IMH眼与最小限度剥离内眦膜皮瓣技术。MH周围的ILM以环形剥离，宽度约为200至300 μm。在上级视网膜上形成舌形内界膜瓣，内界膜下缘不剥离。然后将ILM瓣翻转以覆盖MH，然后进行流体-空气交换和空气或硅填充。在基线和每次术后随访时进行光谱域光学相干断层扫描（SD-OCT）和面OCT的形态学评估、最佳矫正视力（BCVA）和多焦视网膜电图（ERG）的功能评估。术前最佳矫正视力为0.83 ± 0.33，术后最佳矫正视力为0.39 ± 0.28（p< 0.001）。结论应用ILM瓣技术进行最小限度的ILM剥离术，可有效地关闭视网膜裂孔，减少视网膜内陷，并能有效地恢复IMH的视力。
BackgroundInternal limiting membrane (ILM) peeling increases the idiopathic macular hole (IMH) closure rate but causes the inner retina dimplings. This study is to introduce a method to minimally peel the ILM, and with the ILM flap to ensure the IMH closure.MethodsTwelve consecutive IMH eyes were treated with the minimal ILM peeling with ILM flap technique. The ILM around the MH is peeled off in an annular shape with a width of approximately 200 to 300 μm. A tongue-shape ILM flap is created in the superior retina and the inferior margin of ILM is not peeled off. The ILM flap is then inverted to cover the MH, followed by fluid-air exchange and air or silicon tamponade. Spectral domain-optical coherence tomography (SD-OCT) anden faceOCT for morphological assessment, best corrected visual acuity (BCVA) and multifocal electroretinogram (ERG) for functional evaluation were performed at baseline and at each postoperative follow-up.ResultsAll the 12 eyes achieved macular hole closure on SD-OCT after surgery (100%). At baseline, the mean preoperative BCVA was 0.83 ± 0.33 and it improved to 0.39 ± 0.28 postoperatively (p< 0.001).En faceOCT showed the inner retinal dimplings were localized only in superior ILM-free retinas (7 eyes). The mERG response density in the central (R1), para-central (R2), R1/R2 ring ratios were remarkably improved at the last follow-up (p= 0.001,p= 0.033,p= 0.018, respectively).ConclusionsThe minimal ILM peeling with ILM flap technique can achieve favorable MH closure with less inner retinal dimplings and has promising visual recovery for IMH eyes.