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Internal limiting membrane translocation for refractory macular holes
  1. Joana Pires1,
  2. Jeroni Nadal2,
  3. Nuno Lourenço Gomes3
  1. 1Department of Ophthalmology, Centro Hospitalar do Baixo Vouga, Porto, Portugal
  2. 2Department of Ophthalmology, Centro de Oftalmología Barraquer, Barcelona, Spain
  3. 3Department of Ophthalmology, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Joana Pires, Avenida Artur Ravara, Aveiro 3814-501, Portugal; jpires13{at}gmail.com

Abstract

Background/aims Closure is more difficult to achieve in macular holes that remain open following a previous unsuccessful pars plana vitrectomy (PPV). We present our results with the internal limiting membrane (ILM) translocation technique that is used to optimise outcomes in refractory macular holes.

Methods A prospective, interventional, case series was conducted. 12 eyes of 12 consecutive patients with incomplete sealing of the macular hole (open and type 2 closure) after a previous PPV with ILM peeling were included. Measured baseline parameters included best-corrected visual acuity (BCVA) and macular hole smallest diameter, base diameter and height. Surgeries were performed by harvesting a fragment of the ILM near the vascular arcades and subsequently placing it inside the hole. Postoperative measured outcomes included macular hole status, foveal contour, outer retina integrity, BCVA and surgery-related complications.

Results Anatomic closure occurred in 11 of 12 eyes (91%). This technique elicited a statistically significant improvement in BCVA (p=0.008). Mean BCVA was 20/400 at study baseline and 20/160 at final follow-up. However, less than 16.7% of cases had a final BCVA of ≥20/63.

Conclusion The ILM translocation technique seems to facilitate persistent idiopathic macular hole closure, where primary surgery with PPV and ILM peeling failed.

  • Treatment Surgery
  • Vitreous
  • Retina
  • Macula

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Footnotes

  • Contributors JP, NLG and JN meet authorship criteria and certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript.

  • Competing interests None declared.

  • Ethics approval Comissão de Ética do Hospital de Braga.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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