The effect comparison of ILM flap and traditional ILM peeling in iMH

Yiqi Chen; Yijun Xu; Xin Ye; Jiafeng Yu; Chenxi Wang; Zhengxi Zhang; Jianbo Mao; Lijun Shen

doi:10.3389/fmed.2023.1103593

The effect comparison of ILM flap and traditional ILM peeling in iMH

Front Med (Lausanne). 2023 Feb 9:10:1103593. doi: 10.3389/fmed.2023.1103593. eCollection 2023.

Authors

Yiqi Chen^{1

2}, Yijun Xu³, Xin Ye², Jiafeng Yu¹, Chenxi Wang¹, Zhengxi Zhang², Jianbo Mao^{1

2}, Lijun Shen^{1

2}

Affiliations

¹ Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
² School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
³ Daxing Teaching Hospital Affiliated to Capital Medical University, Beijing, China.

Abstract

Purpose: To compare the changes in anatomical structure and visual function after idiopathic macular hole (iMH) treatment with internal limiting membrane (ILM) peeling and inverted ILM flap and determine the value of the inverted ILM flap for the treatment of iMH.

Methods: Forty-nine patients with iMH (49 eyes) were included in this study and followed up for 1 year (12 months) after treatment with inverted ILM flap and ILM peeling respectively. The main foveal parameters assessed included the preoperative minimum diameter (MD), intraoperative residual fragments, and postoperative ELM reconstruction. Visual function was assessed using best-corrected visual acuity.

Results: The hole closure rate was 100% for 49 patients; 15 patients were treated with the inverted ILM flap, and 34 patients underwent ILM peeling. There were no differences between the postoperative best-corrected visual acuities and the rates of ELM reconstruction for the flap and peeling groups with different MDs. In the flap group, ELM reconstruction was associated with the preoperative MD, presence of an ILM flap, and hyperreflective changes in the inner retina 1 month after surgery. In the peeling group, ELM reconstruction was associated with the preoperative MD, intraoperative residual fragments at the hole edge, and hyperreflective changes in the inner retina.

Conclusion: The inverted ILM flap and the ILM Peeling were both able to obtain high closure rate. However, the inverted ILM flap showed no obvious advantages related to anatomical morphology and visual function over ILM peeling.

Keywords: idiopathic macular hole; internal limiting membrane; optical coherence tomography; the inverted ILM flap treatment; visual function.