Cargando…

Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial

BACKGROUND: The anatomical success rate of macular hole surgery ranges around 93–98%. However, the prognosis of large macular holes is generally poor. The study was conducted to compare the anatomical and visual outcomes of Internal Limiting Membrane (ILM) peeling vis-a-vis inverted ILM flap for the...

Descripción completa

Detalles Bibliográficos
Autores principales: Kannan, Naresh Babu, Kohli, Piyush, Parida, Haemoglobin, Adenuga, O. O., Ramasamy, Kim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054750/
https://www.ncbi.nlm.nih.gov/pubmed/30029621
http://dx.doi.org/10.1186/s12886-018-0826-y
_version_ 1783341057452277760
author Kannan, Naresh Babu
Kohli, Piyush
Parida, Haemoglobin
Adenuga, O. O.
Ramasamy, Kim
author_facet Kannan, Naresh Babu
Kohli, Piyush
Parida, Haemoglobin
Adenuga, O. O.
Ramasamy, Kim
author_sort Kannan, Naresh Babu
collection PubMed
description BACKGROUND: The anatomical success rate of macular hole surgery ranges around 93–98%. However, the prognosis of large macular holes is generally poor. The study was conducted to compare the anatomical and visual outcomes of Internal Limiting Membrane (ILM) peeling vis-a-vis inverted ILM flap for the treatment of idiopathic large Full-Thickness Macular Holes (FTMH). METHODS: This was a prospective randomized control trial. The study included patients with idiopathic FTMH, with a minimum diameter ranging from 600 to 1500 μm. The patients were randomized into Group A (ILM peeling) and Group B (inverted ILM flap). The main outcome measures were anatomical and visual outcome at the end of 6 months. Anatomical success was defined as flattening of macular hole with resolution of the subretinal cuff of fluid and neurosensory retina completely covering the fovea. RESULTS: There were 30 patients in each group. The mean minimum diameters in Group A and B were 759.97 ± 85.01 μm and 803.33 ± 120.65 μm respectively (p = 0.113). The mean base diameter in group A and B was 1304.50 ± 191.59 μm and 1395.17 ± 240.56 μm respectively (p = 0.112). The anatomical success rates achieved in Group A and B were 70.0 and 90.0% respectively (p = 0.125). The mean best-corrected visual acuity (BCVA) after 6 months was logMAR 0.65 ± 0.25 (Snellen equivalent, 20/89) in Group A and logMAR 0.53 ± 0.20 (Snellen equivalent, 20/68) in Group B (p = 0.060). The mean improvement in BCVA was 1.4 lines and 2.1 lines in groups A and B respectively (p = 0.353). BCVA≥20/60 was achieved by 13.3 and 20.0% in group A and B respectively (p = 0.766). CONCLUSION: The anatomical and functional outcome of Inverted ILM flap technique in large FTMH is statistically similar to that seen in conventional ILM peeling. TRIAL REGISTRATION: Clinical Trials Registry – India (Indian Medical Research) CTRI/2017/11/010474. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12886-018-0826-y) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6054750
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-60547502018-07-23 Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial Kannan, Naresh Babu Kohli, Piyush Parida, Haemoglobin Adenuga, O. O. Ramasamy, Kim BMC Ophthalmol Research Article BACKGROUND: The anatomical success rate of macular hole surgery ranges around 93–98%. However, the prognosis of large macular holes is generally poor. The study was conducted to compare the anatomical and visual outcomes of Internal Limiting Membrane (ILM) peeling vis-a-vis inverted ILM flap for the treatment of idiopathic large Full-Thickness Macular Holes (FTMH). METHODS: This was a prospective randomized control trial. The study included patients with idiopathic FTMH, with a minimum diameter ranging from 600 to 1500 μm. The patients were randomized into Group A (ILM peeling) and Group B (inverted ILM flap). The main outcome measures were anatomical and visual outcome at the end of 6 months. Anatomical success was defined as flattening of macular hole with resolution of the subretinal cuff of fluid and neurosensory retina completely covering the fovea. RESULTS: There were 30 patients in each group. The mean minimum diameters in Group A and B were 759.97 ± 85.01 μm and 803.33 ± 120.65 μm respectively (p = 0.113). The mean base diameter in group A and B was 1304.50 ± 191.59 μm and 1395.17 ± 240.56 μm respectively (p = 0.112). The anatomical success rates achieved in Group A and B were 70.0 and 90.0% respectively (p = 0.125). The mean best-corrected visual acuity (BCVA) after 6 months was logMAR 0.65 ± 0.25 (Snellen equivalent, 20/89) in Group A and logMAR 0.53 ± 0.20 (Snellen equivalent, 20/68) in Group B (p = 0.060). The mean improvement in BCVA was 1.4 lines and 2.1 lines in groups A and B respectively (p = 0.353). BCVA≥20/60 was achieved by 13.3 and 20.0% in group A and B respectively (p = 0.766). CONCLUSION: The anatomical and functional outcome of Inverted ILM flap technique in large FTMH is statistically similar to that seen in conventional ILM peeling. TRIAL REGISTRATION: Clinical Trials Registry – India (Indian Medical Research) CTRI/2017/11/010474. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12886-018-0826-y) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-20 /pmc/articles/PMC6054750/ /pubmed/30029621 http://dx.doi.org/10.1186/s12886-018-0826-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kannan, Naresh Babu
Kohli, Piyush
Parida, Haemoglobin
Adenuga, O. O.
Ramasamy, Kim
Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title_full Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title_fullStr Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title_full_unstemmed Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title_short Comparative study of inverted internal limiting membrane (ILM) flap and ILM peeling technique in large macular holes: a randomized-control trial
title_sort comparative study of inverted internal limiting membrane (ilm) flap and ilm peeling technique in large macular holes: a randomized-control trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054750/
https://www.ncbi.nlm.nih.gov/pubmed/30029621
http://dx.doi.org/10.1186/s12886-018-0826-y
work_keys_str_mv AT kannannareshbabu comparativestudyofinvertedinternallimitingmembraneilmflapandilmpeelingtechniqueinlargemacularholesarandomizedcontroltrial
AT kohlipiyush comparativestudyofinvertedinternallimitingmembraneilmflapandilmpeelingtechniqueinlargemacularholesarandomizedcontroltrial
AT paridahaemoglobin comparativestudyofinvertedinternallimitingmembraneilmflapandilmpeelingtechniqueinlargemacularholesarandomizedcontroltrial
AT adenugaoo comparativestudyofinvertedinternallimitingmembraneilmflapandilmpeelingtechniqueinlargemacularholesarandomizedcontroltrial
AT ramasamykim comparativestudyofinvertedinternallimitingmembraneilmflapandilmpeelingtechniqueinlargemacularholesarandomizedcontroltrial