Cargando…

Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes

PURPOSE: An inverted ILM flap might be accidentally separated from the retina or sucked away during surgery for large macular holes (MHs). This article is to determine the efficacy of a new inverted pedicled internal limiting membrane (ILM) flap attached to an optic disc with an autologous blood clo...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Lishuai, Xi, Huiyu, Chen, Jiayu, Sheng, Aiqin, Fan, Wei, Li, Suyan, Liu, Haiyang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361828/
https://www.ncbi.nlm.nih.gov/pubmed/37483314
http://dx.doi.org/10.1155/2023/7640476
_version_ 1785076294235455488
author Zhang, Lishuai
Xi, Huiyu
Chen, Jiayu
Sheng, Aiqin
Fan, Wei
Li, Suyan
Liu, Haiyang
author_facet Zhang, Lishuai
Xi, Huiyu
Chen, Jiayu
Sheng, Aiqin
Fan, Wei
Li, Suyan
Liu, Haiyang
author_sort Zhang, Lishuai
collection PubMed
description PURPOSE: An inverted ILM flap might be accidentally separated from the retina or sucked away during surgery for large macular holes (MHs). This article is to determine the efficacy of a new inverted pedicled internal limiting membrane (ILM) flap attached to an optic disc with an autologous blood clot (ABC) technique for the treatment of large MHs. METHODS: An inverted pedicled ILM flap connected to the optic disc with ABC was used to treat 12 consecutive patients with significant macular holes (>600 m). The ILM was first peeled off around MH as a semidiameter of about 1.5 diameters of the optic disc. The superior residual ILM was used to produce a pedicled ILM flap that was connected to the optic disc and was later inverted to cover the MH. The macular hole was covered with a repositioned flap larger than 2 MH diameters in an inverted way. ABC was used to fasten the flap, followed by fluid-air exchange with air or C3F8 as tamponade. Spectral domain-optical coherence tomography (SD-OCT) and best-corrected visual acuity (BCVA) were performed at each postoperative follow-up. RESULTS: The mean aperture and base macular hole diameters were 737.9 ± 109.6 µm (range, 607–982 µm) and 1244.3 ± 227.4 µm (range, 975–1658 µm). All macular holes (100%) were closed after a single surgery without intraoperative or postoperative complications related to the ILM transposition technique. At the last postoperative visit, we found one eye with a U-shaped closure, three eyes with W-shaped closures, and eight eyes with V-shaped closures. No postoperative flap closures were noted in all cases. The preoperative mean BCVA was 1.5 ± 0.3 (range, 1.1–2.0). After a mean follow-up of 5.3 ± 4.8 (range, 3–16) months, the postoperative mean BCVA was 0.8 ± 0.2 (range, 0.6–1.1), and the difference was statistically significant (p < 0.05). CONCLUSION: This novel technique is safe and suitable for large MHs and can be an alternative option for accidental ILM flap loss during other inverted ILM flap operations.
format Online
Article
Text
id pubmed-10361828
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-103618282023-07-22 Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes Zhang, Lishuai Xi, Huiyu Chen, Jiayu Sheng, Aiqin Fan, Wei Li, Suyan Liu, Haiyang J Ophthalmol Research Article PURPOSE: An inverted ILM flap might be accidentally separated from the retina or sucked away during surgery for large macular holes (MHs). This article is to determine the efficacy of a new inverted pedicled internal limiting membrane (ILM) flap attached to an optic disc with an autologous blood clot (ABC) technique for the treatment of large MHs. METHODS: An inverted pedicled ILM flap connected to the optic disc with ABC was used to treat 12 consecutive patients with significant macular holes (>600 m). The ILM was first peeled off around MH as a semidiameter of about 1.5 diameters of the optic disc. The superior residual ILM was used to produce a pedicled ILM flap that was connected to the optic disc and was later inverted to cover the MH. The macular hole was covered with a repositioned flap larger than 2 MH diameters in an inverted way. ABC was used to fasten the flap, followed by fluid-air exchange with air or C3F8 as tamponade. Spectral domain-optical coherence tomography (SD-OCT) and best-corrected visual acuity (BCVA) were performed at each postoperative follow-up. RESULTS: The mean aperture and base macular hole diameters were 737.9 ± 109.6 µm (range, 607–982 µm) and 1244.3 ± 227.4 µm (range, 975–1658 µm). All macular holes (100%) were closed after a single surgery without intraoperative or postoperative complications related to the ILM transposition technique. At the last postoperative visit, we found one eye with a U-shaped closure, three eyes with W-shaped closures, and eight eyes with V-shaped closures. No postoperative flap closures were noted in all cases. The preoperative mean BCVA was 1.5 ± 0.3 (range, 1.1–2.0). After a mean follow-up of 5.3 ± 4.8 (range, 3–16) months, the postoperative mean BCVA was 0.8 ± 0.2 (range, 0.6–1.1), and the difference was statistically significant (p < 0.05). CONCLUSION: This novel technique is safe and suitable for large MHs and can be an alternative option for accidental ILM flap loss during other inverted ILM flap operations. Hindawi 2023-07-14 /pmc/articles/PMC10361828/ /pubmed/37483314 http://dx.doi.org/10.1155/2023/7640476 Text en Copyright © 2023 Lishuai Zhang et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Zhang, Lishuai
Xi, Huiyu
Chen, Jiayu
Sheng, Aiqin
Fan, Wei
Li, Suyan
Liu, Haiyang
Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title_full Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title_fullStr Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title_full_unstemmed Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title_short Inverted Pedicled Internal Limiting Membrane Flap Attached to an Optic Disc with Autologous Blood Clot for Large Macular Holes
title_sort inverted pedicled internal limiting membrane flap attached to an optic disc with autologous blood clot for large macular holes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361828/
https://www.ncbi.nlm.nih.gov/pubmed/37483314
http://dx.doi.org/10.1155/2023/7640476
work_keys_str_mv AT zhanglishuai invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT xihuiyu invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT chenjiayu invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT shengaiqin invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT fanwei invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT lisuyan invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes
AT liuhaiyang invertedpedicledinternallimitingmembraneflapattachedtoanopticdiscwithautologousbloodclotforlargemacularholes