Efficacy of Internal Limiting Membrane Flap Techniques with Vitrectomy for Macular Detachment Associated with an Optic Disc Pit

Ophthalmologica. 2019;242(1):38-48. doi: 10.1159/000495621. Epub 2019 Mar 22.

Abstract

Purpose: To compare the anatomical and functional outcome of adjuvant pars plana vitrectomy (PPV) procedures using the techniques of translocation of an internal limiting membrane (ILM) flap and transplantation of an inverted ILM flap for the treatment of chronic and/or refractory optic disc pit (ODP) maculopathy.

Methods: In this prospective interventional case series study, 9 patients (9 eyes) with chronic and/or refractory ODP maculopathy underwent PPV with either translocation of an ILM flap or transplantation of an inverted ILM flap as adjuvant techniques along with gas tamponade. The anatomical success, rates of macular reattachment, and visual improvement were assessed.

Results: The mean preoperative central retinal thickness (CRT) was 723.4 µm (range: 366-1,151). The mean postoperative CRT was 398.1 ± 212.2 µm (range: 210-758). An increased preoperative CRT was associated with a lower chance of postoperative reattachment of the macula (p = 0.047). The overall reattachment rate at the end of the follow-up period was 56% (n = 5). The mean preoperative visual acuity (logMAR unit [Snellen acuity]) was 0.48 (20/60) (range: 1.30 [20/400] to 0.10 [20/25]). The mean change in best corrected visual acuity (BCVA) was 0.48 ± 0.233 logMAR units (approx. 3 lines of visual improvement).

Conclusions: ILM flap techniques are logical and straightforward approaches as adjuvants to PPV treatment of ODP maculopathy. They could be viable adjuvant treatments for improvement in BCVA and CRT in patients with ODP maculopathy.

Keywords: Flap; Internal limiting membrane; Optic disc pit maculopathy; Optical coherence tomography; Pars plana vitrectomy; Peel.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Basement Membrane / diagnostic imaging
  • Basement Membrane / surgery*
  • Child
  • Endotamponade
  • Eye Abnormalities / complications*
  • Eye Abnormalities / diagnostic imaging
  • Female
  • Fluorocarbons / administration & dosage
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Optic Disk / abnormalities*
  • Optic Disk / diagnostic imaging
  • Prospective Studies
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Surgical Flaps*
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy / methods*
  • Young Adult

Substances

  • Fluorocarbons
  • perflutren