scholarly journals Double Internal Limiting Membrane Insertion for Macular Hole-Associated Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
San-Ni Chen ◽  
Chung-May Yang
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Membrane Insertion ◽  
Ilm Peeling ◽  
Modified Technique ◽  
Fluid Exchange ◽  
Registration Number ◽  
Pars Plana

Purpose. To describe a modified technique of internal limiting membrane (ILM) insertion for macular hole- (MH-) associated retinal detachment (RD) in highly myopic eyes. Methods. Nine eyes underwent pars plana vitrectomy, cortical vitreous removal, and fovea-sparing ILM peeling. Double ILM insertion into the hole was performed with inverted perifoveal ILM and a free ILM flap followed by air-fluid exchange. Results. Two of the 9 eyes had perifoveal ILM partially torn after cortical vitreous or epiretinal removal. All eyes had the ILM plug stabilized within the MH after double ILM insertion. Postoperatively, MH was sealed with the retina reattached in all the eyes. Conclusion. Double ILM insertion may further secure the ILM flap in place in the eyes with MH-associated RD, especially in cases in which insufficient perifoveal ILM was left. This trial is registered with the clinical registration number Clinicaltrials.gov NCT03174639.

Foveal microstructure and visual outcomes of myopic macular hole surgery with or without the inverted internal limiting membrane flap technique

2018 ◽  
Vol 103 (10) ◽  
pp. 1495-1502 ◽  
Author(s):  
Xu-Ting Hu ◽  
Qin-Tuo Pan ◽  
Jing-Wei Zheng ◽  
Zong-Duan Zhang
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Flap Technique ◽  
Hyperreflective Foci ◽  
Retinal Reattachment ◽  
Pars Plana ◽  
Myopic Macular Hole

PurposeThe aim of this study was to determine the effect of the inverted internal limiting membrane (ILM) flap technique on the macular hole (MH) closure and foveal microstructure recovery of patients with highly myopic MH.MethodsPars plana vitrectomy and gas tamponade with the inverted ILM flap technique (19 eyes) or with the ILM peeling technique (21 eyes) were performed in patients with highly myopic MH with or without retinal detachment. The rate of MH closure and retinal reattachment, the reconstructive anatomical change of the foveal microstructure and the best-corrected visual acuities (BCVA) of the two groups were compared.ResultsThe anatomic closure rate was statistically significantly higher in the inverted group (100%) than in the peeling group (66.7%; p=0.009). All eyes with MH retinal detachment had successful retinal reattachment in these two groups. However, the rate of the external limiting membrane (ELM) and ellipsoid zone (EZ) (p=0.020), as well as gliosis (p=0.049) in macular area, detected by OCT, was significantly greater in the inverted group than in the peeling group. The postoperative BCVA was significantly better in the eyes with ELM, EZ (p=0.031) and gliosis (p=0.008), but without hyperreflective foci (p=0.001).ConclusionsThese findings demonstrate that the inverted ILM flap technique has better efficacy than the ILM peeling technique for patients with myopic MH in closure rate, foveal microstructure and postoperative BCVA.

scholarly journals The Characteristics of Patient with Macular Hole After Pars Plana Vitrectomy (PPV) and Internal Limiting Membran (ILM) Peeling in Cicendo Eye Hospital National Eye Center, Bandung

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Rani Pitta Omas
Keyword(s):  
Prognostic Factor ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Visual Disturbance ◽  
Ilm Peeling ◽  
Pars Plana ◽  
Anatomical Success ◽  
Very High ◽  
Remarkable Progress

Introduction : Macular hole (MH) can cause severe visual disturbance, but remarkable progress has been achieved in surgical treatment for eyes with this condition. Vitrectomy with internal limiting membrane (ILM) peeling allows a very high success rate for MH closure (approaching 90%). To compare characteristics patients with closed and unclosed macular hole after pars plana vitrectomy (PPV) surgery and internal limiting membran (ILM) peeling. Method : This was retrospective study which data was obtain from patient’s medical records who underwent PPV and ILM peeling since July 1st to December 31th 2018. Results :  27 eyes from 25 patients had MH surgery. 20 eyes (74%)  had closed MH and 7 (26%) eyes unclosed MH after surgery. HFF value before surgery was 1,34 ± 0,90 and MHI was 1,09 ± 0,81 in closed MH. Meanwhile in unclosed MH, HFF value before surgery 0,53 ± 0,12 and MHI was 0,75 ±0,10. MHI ≥0,5 and HFF value ≥ 0,9 had a good prognostic factor. Conclusion : Despite of good prognostic factor from OCT measurement and achieve anatomical success,  foveal microstructure also important in  visual recovery after MH surgery.

scholarly journals Eccentric Macular Hole after Pars Plana Vitrectomy for Idiopathic Macular Hole: A Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Irini Chatziralli ◽  
George Theodossiadis ◽  
Maria Douvali ◽  
Alexandros A. Rouvas ◽  
Panagiotis Theodossiadis
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Pars Plana ◽  
23 Gauge ◽  
Retinal Hole ◽  
The Right

Introduction: Postoperative eccentric macular hole (MH) formation is an uncommon complication after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for epiretinal membrane or MH treatment. Herein, we present a case of eccentric MH formation after PPV with ILM peeling for MH. Case Description: A 72-year-old female patient underwent 23-gauge PPV with ILM peeling for idiopathic MH in her right eye. The visual acuity was 6/24 in the right eye. One week postoperatively the retina was attached and the MH seemed to be closed, while visual acuity was 6/12. One month after PPV, there was a single eccentric retinal hole below the macula, which was detected at the fundoscopy and was confirmed by OCT. The visual acuity was 6/9 and the patient referred no symptoms. No further intervention was attempted, and at the 6-month follow-up the visual acuity and the size of the eccentric MH remained stable. Conclusions: Eccentric MHs can develop after PPV and are usually managed conservatively by observation.

A customized posterior scleral reinforcement for myopic macular hole with retinal detachment and posterior staphyloma: A case report

2020 ◽  
pp. 112067212092726 ◽  
Author(s):  
Rino Frisina
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Epiretinal Membranes ◽  
Posterior Staphyloma ◽  
Retinal Reattachment ◽  
Pars Plana ◽  
Posterior Scleral Reinforcement ◽  
Myopic Macular Hole

The author describes a customized posterior scleral reinforcement, its manufacturing method, the rationale of its therapeutic effect, and the surgical technique of its implantation. A 54-year-old female patient with a case history of myopic macular hole with retinal detachment and posterior staphyloma, refractory to pars plana vitrectomy and peeling of internal limiting membrane, underwent posterior scleral reinforcement treatment. Retinal reattachment and macular hole closure were obtained. Best corrected visual acuity increased from light perception to 20/160 Snellen. The pars plana vitrectomy is mandatory to remove vitreoretinal tractions and epiretinal membranes; furthermore, the internal limiting membrane peeling makes retina less rigid. However, it may not be sufficient to allow retinal reattachment and it plays no preventive role in limiting posterior staphyloma progression. The rationale of posterior scleral reinforcement is to reduce retinal stretching, to contain posterior staphyloma, and to limit its progression over time.

scholarly journals Missing Internal Limiting Membrane during Macular Hole Repair in Alport Syndrome

2021 ◽  
pp. 320-323
Author(s):  
Sarah G. Chaudhry ◽  
Gerald Liew ◽  
Adrian T. Fung
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Alport Syndrome ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Full Thickness Macular Hole ◽  
Pars Plana ◽  
Vitrectomy Surgery

The aim of this manuscript is to describe a novel retinal finding of Alport syndrome during surgical management of an associated macular hole. A retrospective chart review of a 65-year-old man with a diagnosis of Alport syndrome confirmed by renal biopsy was found to have an associated full-thickness macular hole. Pars-plana vitrectomy surgery with internal limiting membrane (ILM) peeling was attempted, but intraoperatively the ILM was found to be absent at the macula. Alport syndrome may be associated with the absence of the ILM. This can complicate attempts at macular hole repair.

scholarly journals Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane

2020 ◽  
pp. bjophthalmol-2020-317478
Author(s):  
Kunihiko Akino ◽  
Norihiro Nagai ◽  
Kazuhiro Watanabe ◽  
Norimitsu Ban ◽  
Toshihide Kurihara ◽  
...  
Keyword(s):  
Visual Field ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Visual Field Defects ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Ilm Peeling ◽  
Idiopathic Epiretinal Membrane ◽  
Pars Plana

Background/AimsPars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.MethodsData of 30 eyes (30 patients; mean age, 66.1 years; 15 men) who underwent PPV for iERM during February 2016–June 2019 and had preoperative and postoperative visual field measurements using standard automated perimetry (Humphrey visual field analyser 30-2 program) were retrospectively analysed. Eyes with diseases other than iERM, including moderate-to-severe cataract or preoperative VFDs were excluded.ResultsVFD, defined by the Anderson and Patella’s criteria, was found in 73.3% of the eyes 1 month after PPV. After age adjustment, internal limiting membrane (ILM) peeling was identified as a risk factor for postoperative VFD (p=0.035; 95% CI 1.173 to 92.8). Postoperative VFD was frequently observed nasally (86.4%, p=0.002), and on optical coherence tomography measurements, ganglion cell layer (GCL) thinning was found temporal to the fovea (p=0.008). Thinning of the superior and inferior retinal nerve fibre layers and of the GCL temporal to the fovea were significant in eyes after ILM peeling (all p<0.05).ConclusionILM peeling may cause inner retinal degeneration and lead to the development of VFDs after PPV, which should be further examined.

scholarly journals Internal Limiting Membrane Peeling for Persistent Submacular Fluid after Successful Repair of Diabetic Tractional Retinal Detachment

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Byung Ju Jung ◽  
Sohee Jeon ◽  
Kook Lee ◽  
Jiwon Baek ◽  
Won Ki Lee
Keyword(s):  
Retinal Detachment ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Effective Treatment Option ◽  
Retrospective Case ◽  
Tractional Retinal Detachment ◽  
Vascular Arcade ◽  
Pars Plana ◽  
Successful Repair

This study is for reporting the outcomes of internal limiting membrane (ILM) peeling on persistent submacular fluid (PSF) after otherwise successful pars plana vitrectomy (PPV) for diabetic tractional retinal detachment (TRD). In this retrospective case series, five consecutive patients (5 eyes) who exhibited PSF following successful repair of diabetic TRD were included. The second operation was performed to remove ILM. The area of ILM peeling was expanded up to the major vascular arcade. Only air tamponade was used. The median interval between the first PPV and the second PPV with ILM peeling was 4.8 months (range: 4–6 months). PSF resolved completely within one (2 eyes) or 2 months after ILM peeling. The median logMAR best-corrected visual acuity (BCVA) was improved from 1.00 (Snellen equivalent 20/200) to 0.70 (Snellen equivalent 20/100). In conclusion, wide ILM peeling is an effective treatment option for PSF subsequent to successful repair of diabetic TRD. ILM peeling might increase the elasticity of retina, thereby allowing the retina to flatten. This procedure can induce faster retinal reattachment in diabetic TRD involving the macula.

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