Is it necessary to cover the macular hole with the inverted internal limiting membrane flap in macular hole surgery? A case report

BMC Ophthalmology

Case Report

David Sai-hung Wong¹  Kenneth Kai-wang Li²  Chung-yee Chung² 

[1] Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong, Hong Kong;Department of Ophthalmology, United Christian Hospital, Room A, 1/F, Block G, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong;Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong, Hong Kong;

关键词: Macular Hole;    Internal Limit Membrane;    Retinal Pigmentary Epithelium;    Internal Limit Membrane Peeling;    Optical Coherence Tomography Scan;   

DOI  :  10.1186/s12886-015-0104-1

 received in 2015-07-03, accepted in 2015-08-14,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundTo report a case of late closure of idiopathic full-thickness macular hole (FTMH) after vitrectomy with the inverted internal limiting membrane (ILM) technique.Case presentationA 68-year-old lady with a stage IV FTMH underwent pars plana vitrectomy with 25 gauge plus transconjunctival system, ILM peeling and gas tamponade. The inverted ILM flap technique was adopted, except that no extra surgical manipulation was used to cover the macular hole with the ILM flap. Surgical outcome was monitored with serial optical coherence tomography (OCT).Complete closure of the FTMH with resolution of intraretinal cystic changes was confirmed on OCT at 16 months postoperatively. Visual acuity improved from a baseline level of 0.1 to 0.4.ConclusionIdiopathic macular hole closure could be delayed to beyond 1 year following the inverted ILM flap technique, especially if the macular hole was not covered with the ILM flap. Not all macular holes that fail to close in the early postoperative period need to be re-operated and there may be no risk of further visual deterioration.

【 授权许可】

CC BY   
© Chung et al. 2015