TY - JOUR
T1 - Surgical results of internal limiting membrane flap inversion and internal limiting membrane peeling for macular hole
AU - Ota, Hiroya
AU - Kunikata, Hiroshi
AU - Aizawa, Naoko
AU - Nakazawa, Toru
N1 - Funding Information:
This paper was supported in part by JST grants from JSPS KAKENHI Grants-in-Aid for Scientific Research (C) (H.K.40360192). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The principal investigator, Dr. Hiroya Ota, and the co-investigator, Dr. Naoko Aizawa, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the analysis. This paper was supported in part by JST grants from JSPS KAKENHI Grants-in-Aid for Scientific Research (C) (H.K.40360192).
Publisher Copyright:
© 2018 Ota et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/9
Y1 - 2018/9
N2 - Purpose The internal limiting membrane (ILM) is a normal part of the retina, and the outcomes of ILM removal have not been fully investigated. ILM flap inversion is a recently developed technique that increases the success rate of macular hole (MH) surgery. Thus, we compared the anatomical closure rate and visual outcome in patients undergoing microincision vitrectomy surgery (MIVS) with ILM flap inversion or conventional ILM peeling for the treatment of MH. Methods The medical records of 90 eyes with MH were reviewed retrospectively. The patients were classified into two groups based on MIVS procedure (group 1: ILM flap inversion, 46 eyes; group 2: ILM peeling, 44 eyes). Results Preoperative characteristics were similar in the two groups, and there were no significant differences in 1 month- or 6 month-postoperative VA between the groups (P = 0.25 and P = 0.42, respectively). However, the surgical success rate was significantly higher in group 1 than group 2 (P = 0.04; 46/46: 100% and 41/44: 93%, respectively). Multiple regression analysis revealed that axial length and MH diameter were independent factors predicting 6-month postoperative BCVA in group 2 (P = 0.001 and P = 0.03, respectively), and that MH diameter was an independent factor predicting 6-month postoperative VA in group 1 (P = 0.03). Logistic regression analysis revealed that axial length (OR = 2.11; P = 0.02; area under the curve: 0.94; cut off score: 28.4 mm) was an independent factor indicating surgical failure in group 2. Conclusion Our results suggest that MIVS with ILM flap inversion might be best suited to treat MH, particularly in patients with high myopia.
AB - Purpose The internal limiting membrane (ILM) is a normal part of the retina, and the outcomes of ILM removal have not been fully investigated. ILM flap inversion is a recently developed technique that increases the success rate of macular hole (MH) surgery. Thus, we compared the anatomical closure rate and visual outcome in patients undergoing microincision vitrectomy surgery (MIVS) with ILM flap inversion or conventional ILM peeling for the treatment of MH. Methods The medical records of 90 eyes with MH were reviewed retrospectively. The patients were classified into two groups based on MIVS procedure (group 1: ILM flap inversion, 46 eyes; group 2: ILM peeling, 44 eyes). Results Preoperative characteristics were similar in the two groups, and there were no significant differences in 1 month- or 6 month-postoperative VA between the groups (P = 0.25 and P = 0.42, respectively). However, the surgical success rate was significantly higher in group 1 than group 2 (P = 0.04; 46/46: 100% and 41/44: 93%, respectively). Multiple regression analysis revealed that axial length and MH diameter were independent factors predicting 6-month postoperative BCVA in group 2 (P = 0.001 and P = 0.03, respectively), and that MH diameter was an independent factor predicting 6-month postoperative VA in group 1 (P = 0.03). Logistic regression analysis revealed that axial length (OR = 2.11; P = 0.02; area under the curve: 0.94; cut off score: 28.4 mm) was an independent factor indicating surgical failure in group 2. Conclusion Our results suggest that MIVS with ILM flap inversion might be best suited to treat MH, particularly in patients with high myopia.
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U2 - 10.1371/journal.pone.0203789
DO - 10.1371/journal.pone.0203789
M3 - Article
C2 - 30212576
AN - SCOPUS:85053250867
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 9
M1 - e0203789
ER -