Dataset Information

An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole.

ABSTRACT:

Introduction

Recurrent or persistent macular holes (MHs) are rare today due to the tendency to carefully peel the internal limiting membrane. Conversely, their treatment is still a challenge for a vitreoretinal surgeon.

Materials and methods

This is a retrospective, consecutive, and nonrandomized study of patients affected by recurrent or persistent MHs treated using small-gauge pars plana vitrectomy (25- or 23-gauge) and an autologous ILM plug, at the Eye Clinic of Azienda Ospedaliera Universitaria Careggi (Florence, Italy) between January 2016 and May 2018. We included 8 eyes of 8 patients in the study. Five patients had a recurrent MH while 3 had a persistent MH. The case series includes patients with myopic eyes and with large macular holes (>400??). Patients were followed up with ophthalmoscopic examinations and swept-source optical coherence tomography (SS-OCT).

Results

The mean age of the patients was 74?years (±4.81 standard deviation (SD)), 3 patients were men and 5 women. The average axial length was 26.28?mm (±2.84 SD). Four patients had an AL???26?mm. The mean MH diameter was 436.5 (±49.82 SD). Average preoperative best-corrected visual acuity (BCVA) was 0.81 logMAR (±0.16 SD) and 20/125 Snellen. The ILM plug has been found integrated in the MH in all the follow-ups.

Conclusion

In our study, an ILM autologous macular transplant was used successfully in 5 cases of macular hole recurrence and 3 cases of macular hole persistence. The anatomical success was achieved in all the cases; 4 patients improved their BCVA, and 4 patients maintained it. No macular alterations such as RPE or retinal atrophy/dystrophy were observed after 6?months.

SUBMITTER: Giansanti F

PROVIDER: S-EPMC6431435 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole.

Giansanti Fabrizio F Tartaro Ruggero R Caporossi Tomaso T Bacherini Daniela D Savastano Alfonso A Barca Francesco F Rizzo Stanislao S

Journal of ophthalmology 20190307

<h4>Introduction</h4>Recurrent or persistent macular holes (MHs) are rare today due to the tendency to carefully peel the internal limiting membrane. Conversely, their treatment is still a challenge for a vitreoretinal surgeon.<h4>Materials and methods</h4>This is a retrospective, consecutive, and nonrandomized study of patients affected by recurrent or persistent MHs treated using small-gauge pars plana vitrectomy (25- or 23-gauge) and an autologous ILM plug, at the Eye Clinic of Azienda Ospeda ...[more]

PMID: 30956814

Similar Datasets

Project description:BackgroundA full-thickness macular hole (FTMH) is a common retinal condition associated with impaired vision. Randomised controlled trials (RCTs) have demonstrated that surgery, by means of pars plana vitrectomy and post-operative intraocular tamponade with gas, is effective for stage 2, 3 and 4 FTMH. Internal limiting membrane (ILM) peeling has been introduced as an additional surgical manoeuvre to increase the success of the surgery; i.e. increase rates of hole closure and visual improvement. However, little robust evidence exists supporting the superiority of ILM peeling compared with no-peeling techniques. The purpose of FILMS (Full-Thickness Macular Hole and Internal Limiting Membrane Peeling Study) is to determine whether ILM peeling improves the visual function, the anatomical closure of FTMH, and the quality of life of patients affected by this disorder, and the cost-effectiveness of the surgery.Methods/designPatients with stage 2-3 idiopathic FTMH of less or equal than 18 months duration (based on symptoms reported by the participant) and with a visual acuity </= 20/40 in the study eye will be enrolled in this FILMS from eight sites across the UK and Ireland. Participants will be randomised to receive combined cataract surgery (phacoemulsification and intraocular lens implantation) and pars plana vitrectomy with postoperative intraocular tamponade with gas, with or without ILM peeling. The primary outcome is distance visual acuity at 6 months. Secondary outcomes include distance visual acuity at 3 and 24 months, near visual acuity at 3, 6, and 24 months, contrast sensitivity at 6 months, reading speed at 6 months, anatomical closure of the macular hole at each time point (1, 3, 6, and 24 months), health related quality of life (HRQOL) at six months, costs to the health service and the participant, incremental costs per quality adjusted life year (QALY) and adverse events.DiscussionFILMS will provide high quality evidence on the role of ILM peeling in FTMH surgery.Trial registrationThis trial is registered with Current Controlled Trials ISRCTN number 33175422 and Clinical Trials.gov identifier NCT00286507.

Dataset Information

An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole.

Introduction

Materials and methods

Results

Conclusion

Publications

An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole.

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