Surgical Outcomes After Inverted Internal Limiting Membrane Flap vs Conventional Peeling for Very Large Macular Holes

• In this retrospective study the anatomical and visual outcomes of inverted flap technique of peeling of internal limiting membrane (ILM) versus standard peeling of ILM for macular holes of basal diameter more than 800 μm were evaluated.
• Patients with very large idiopathic macular holes more than 800 μm in basal diameter were included.
• The primary endpoint was the rate of hole closure at 6 months after surgery.
• The secondary outcome measure was the change in best-corrected visual acuity at 6 months after surgery.
• This multicenter series concludes, inverted ILM flap technique did not lead to significantly higher anatomical closure rates than conventional ILM peeling in large macular holes more than 800 μm in diameter.

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• This study retrospectively evaluated the anatomical and visual outcomes with two different surgical techniques for peeling of the internal limiting membrane (ILM) for very large macular holes.
• The authors compared the inverted flap technique and standard peeling and found no significant differences between the two in terms of hole closure rates.
• However, the inverted flap technique resulted in a statistically non-significant improvement in visual acuity compared with the standard technique.
• These findings indicate no advantage of the inverted flap technique over the standard technique for ILM peeling, although some studies have demonstrated a benefit in the past.

REFERENCE

Narayanan R, Singh SR, Taylor S, Berrocal MH, Chhablani J, Tyagi M, Ohno-Matsui K, Pappuru RR, Apte RS. SURGICAL OUTCOMES AFTER INVERTED INTERNAL LIMITING MEMBRANE FLAP VERSUS CONVENTIONAL PEELING FOR VERY LARGE MACULAR HOLES. Retina. 2019 Aug;39(8):1465-1469