Effects of internal limiting membrane stripping and inverted internal limiting membrane flap covering on visual acuity and retinal structure after idiopathic macular hole surgery
Effects of internal limiting membrane stripping and inverted internal limiting membrane flap covering on visual acuity and retinal structure after idiopathic macular hole surgery
Objective To evaluate the effect of inverted internal limiting membrane(ILM)flap covering and ILM stripping in idiopathic macular hole(IMHs)surgery,and to observe the effect of the two surgical methods on macular hole closure,outer retinal structure and postoperative visual acuity.Methods The clinical data of 54 eyes of 54 patients with IMHs treated in Xuzhou Municipal Hospital from June 2021 to March 2022 were retrospectively analyzed.The patients were divided into two groups according to different surgical methods:28 eyes of 28 patients underwent ILM stripping and 26 eyes of 26 patients underwent ILM inverted covering.The best corrected visual acuity(BCVA),macular hole closure morphology and outer retinal structure were compared between the two groups at 6 months after operation.Results At 6 months after operation,the visual acuity of the two groups was improved compared with that before operation,and the difference was statistically significant(t1=12.67,P1＜0.001;t2=11.47,P2＜0.001).Postoperative visual acuity in ILM turnover flap group was better than that in ILM stripping group(t=2.20,P=0.033).At 6 months after operation,24(85.7％)cases of macular hole(MH)were successfully closed in the stripping group,including 11(45.8％)cases with U-shaped closure,10(41.7％)cases with intact EZ and 17(70.8％)cases with intact ELM.In the inverted flap group,24(92.3％)cases had MH successful closure,including 18(75.05％)cases of U-type closure,16(66.7％)cases of complete EZ closure,and 20(83.3％)cases of complete EIM closure.The proportions of U-type closure,EZ and ELM recovery in the flap cover group were higher than those in the stripping group.Conclusion The two surgical methods are effective in improving the closure rate of MH.The inverted ILM flap covering technique is more conducive to the healing of the macular hole along the original anatomical shape,and it can effectively restore the outer retinal structure after surgery,and improve the prognosis of patients.
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