THE INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE IS NOT RECOMMENDED FOR THE TREATMENT OF LARGE MACULAR HOLES SMALLER THAN 650 µ m

Abstract

Purpose: To compare the anatomical and functional outcomes of the inverted flap technique versus conventional internal limited membrane (ILM) peeling in large idiopathic full-thickness macular holes <650 µ m.

Methods: Retrospective comparative study. Patients with large idiopathic macular holes <650 µ m who underwent either the inverted ILM flap technique (IFT) or the ILM peeling were investigated. The main outcomes included the macular hole closure rate, recovery rates of the external limiting membrane and ellipsoid zone, and best-corrected visual acuity at 1, 3, and 6 months postoperatively.

Results: Sixty-nine eyes of 69 patients who underwent the IFT (n = 32, Group A) or ILM peeling (n = 37, Group B) were included. In both groups, a significant best-corrected visual acuity improvement was acquired throughout the follow-up period. The mean best-corrected visual acuity increased at each follow-up visit in both groups ( P < 0.001). However, the IFT group showed poorer visual results than the ILM peeling group at all time points ( P = 0.039, 0.005, 0.006). The external limiting membrane recovery rate in the ILM peeling group (78.3%, 29/37 eyes) was higher than that in the IFT group (53.1%, 17/32 eyes) at 6 months after surgery ( P = 0.079).

Conclusion: The IFT resulted in poorer external limiting membrane and visual recovery than ILM peeling, suggesting that the IFT is not a suitable option for repairing large macular holes <650 µ m.