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Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap

PURPOSE: To report a case in which an internal limiting membrane (ILM) flap that was used to cover an idiopathic macular hole (MH) during pars plana vitrectomy (PPV) with the inverted internal limiting membrane flap technique partially detached from the retina. Most interestingly, the flap fell back...

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Autores principales: Kawamata, Yuto, Baba, Takayuki, Yokouchi, Hirotaka, Yamamoto, Shuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076646/
https://www.ncbi.nlm.nih.gov/pubmed/33937583
http://dx.doi.org/10.1016/j.ajoc.2021.101089
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author Kawamata, Yuto
Baba, Takayuki
Yokouchi, Hirotaka
Yamamoto, Shuichi
author_facet Kawamata, Yuto
Baba, Takayuki
Yokouchi, Hirotaka
Yamamoto, Shuichi
author_sort Kawamata, Yuto
collection PubMed
description PURPOSE: To report a case in which an internal limiting membrane (ILM) flap that was used to cover an idiopathic macular hole (MH) during pars plana vitrectomy (PPV) with the inverted internal limiting membrane flap technique partially detached from the retina. Most interestingly, the flap fell back spontaneously to re-cover the MH. OBSERVATIONS: A 70-year-old woman presented with a full-thickness MH, and her vision was 20/400. She underwent PPV with an inverted ILM flap and air tamponade. When the intraocular gas was absorbed, the ILM flap detached but was held to the retina where it had not been peeled and the MH was open. Her visual acuity at this time was 20/400. The patient did not want further treatment and was followed by observation alone. At three months after the initial surgery, the ILM flap was noted to have spontaneously re-covered the MH, and her visual acuity improved to 20/200. At 6 months after the re-covering, the flap remained over the MH and the visual acuity remained at 20/200. CONCLUSIONS AND IMPORTANCE: Surgeons should be aware that it is possible for an ILM flap created by the inverted ILM flap technique to partially detach from the retina after the tamponade gas is resorbed. Most importantly, the flap can return to re-cover the MH spontaneously.
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spelling pubmed-80766462021-04-29 Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap Kawamata, Yuto Baba, Takayuki Yokouchi, Hirotaka Yamamoto, Shuichi Am J Ophthalmol Case Rep Case Report PURPOSE: To report a case in which an internal limiting membrane (ILM) flap that was used to cover an idiopathic macular hole (MH) during pars plana vitrectomy (PPV) with the inverted internal limiting membrane flap technique partially detached from the retina. Most interestingly, the flap fell back spontaneously to re-cover the MH. OBSERVATIONS: A 70-year-old woman presented with a full-thickness MH, and her vision was 20/400. She underwent PPV with an inverted ILM flap and air tamponade. When the intraocular gas was absorbed, the ILM flap detached but was held to the retina where it had not been peeled and the MH was open. Her visual acuity at this time was 20/400. The patient did not want further treatment and was followed by observation alone. At three months after the initial surgery, the ILM flap was noted to have spontaneously re-covered the MH, and her visual acuity improved to 20/200. At 6 months after the re-covering, the flap remained over the MH and the visual acuity remained at 20/200. CONCLUSIONS AND IMPORTANCE: Surgeons should be aware that it is possible for an ILM flap created by the inverted ILM flap technique to partially detach from the retina after the tamponade gas is resorbed. Most importantly, the flap can return to re-cover the MH spontaneously. Elsevier 2021-04-14 /pmc/articles/PMC8076646/ /pubmed/33937583 http://dx.doi.org/10.1016/j.ajoc.2021.101089 Text en © 2021 Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Kawamata, Yuto
Baba, Takayuki
Yokouchi, Hirotaka
Yamamoto, Shuichi
Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title_full Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title_fullStr Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title_full_unstemmed Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title_short Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
title_sort partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076646/
https://www.ncbi.nlm.nih.gov/pubmed/33937583
http://dx.doi.org/10.1016/j.ajoc.2021.101089
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