Purpose: To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery. Methods: Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated. Results: All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022). Conclusions: The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.

Comparison of inverted flap and subretinal aspiration technique in full-thickness macular hole surgery: a randomized controlled study

Iovino, Claudio;Caminiti, Giulia;Peiretti, Enrico
2018

Abstract

Purpose: To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery. Methods: Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated. Results: All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022). Conclusions: The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.
Inverted internal limiting membrane flap; Macular hole surgery; Pars plana vitrectomy; Subretinal aspiration;
Inverted internal limiting membrane flap; Macular hole surgery; Pars plana vitrectomy; Subretinal aspiration
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11584/242458
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