This study compares the anatomical and visual outcomes in a large series of patients affected by idiopathic macular holes larger than 400 µm treated using pars plana vitrectomy and gas tamponade combined with internal limiting membrane (ILM) peeling or the inverted internal limiting membrane flap technique. A part of the participants will receive internal limiting membrane peeling,whil the other will receive the inverted internal limiting membrane flap technique.
Vitrectomy is the standard treatment for idiopathic macular holes (IMHs) and is combined with removal of the internal limiting membrane (ILM) to improve anatomical outcomes.However, surgical closure is not achieved after a single operation in all cases, and patients with long-standing MHs or highly myopic eyes are challenging to treat.Various surgical strategies have been introduced to improve postoperative outcomes for these cases. Michalewska et al. have reported an inverted ILM flap technique for large MHs. The ILM around the MH was left to cover or fill the hole and showed a better anatomical closure rate and visual outcome than ILM peeling for large MHs. Nevertheless, the functional and anatomic outcomes of the ILM flap technique have not been investigated as extensively as the ILM peeling technique and have yet to be confirmed by research comparing the ILM flap technique with the conventional procedure.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
100
The internal limiting membrane around the MH was left to cover the hole
The internal limiting membrane around the MH was left to fill the hole
the internal limiting membrane was discarded
Department of Ophthalmology, The Second Affiliated Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
RECRUITINGMH status
MH status (open, flat open or closed)
Time frame: at 3 months after surgery
IS/OS line interruption width
IS/OS line interruption width were gauged with spectral-domain optical coherence tomography
Time frame: at 3 months after surgery
Change from Baseline IS/OS line interruption width at 3 months
IS/OS line interruption width were gauged with spectral-domain optical coherence tomography
Time frame: at 3 months after surgery
Baseline best-corrected visual acuity
best-corrected visual acuity were gauged with EDTRS charts,recorded in decimals and was converted to logarithm of the minimum angle of resolution units for statistical analysis
Time frame: at 3 months after surgery
Change from Baseline best-corrected visual acuity at 3 months
best-corrected visual acuity were gauged with EDTRS charts,recorded in decimals and was converted to logarithm of the minimum angle of resolution units for statistical analysis
Time frame: at 3 months after surgery
visual function
visual function were gauged with national eye institute visual function questionnaire-25((NEI VFQ-25)
Time frame: at 3 months after surgery
Change from Baseline visual function at 3 months
visual function were gauged with national eye institute visual function questionnaire-25((NEI VFQ-25)
Time frame: at 3 months after surgery
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