Author: Christoph Leisser
Co-authors: Oliver Findl
Abstract
Purpose: Foveal sparing ILM peeling, initially proposed for myopic foveoschisis to minimize surgical induced trauma on the retinal structures for patients, also showed promising results for patients undergoing macular hole repair. Aim of this retrospective analysis is to report about advantages and limitations of this technique.Setting: Vienna Institute for Research in Ocular Surgery at the Hanusch-Hospital, Vienna, Austria
Methods: A retrospective analysed case series of patients scheduled for pars plana vitrectomy with foveal sparing ILM peeling with ILM flap transposition over the macular hole.
Results: Nineteen patients were included into this analysis. In 18 cases foveal sparing ILM peeling with ILM flap transposition could be performed successfully, while in one case the ILM unintentionally was peeled including the foveal rim. In the early phase of utilizing this technique (n=4) we left a broad foveal sparing area of ILM, resulting in a macular closure rate of 50%. Therefore, the technique was adapted with leaving a narrow foveal sparing area of ILM resulting in a macular hole closure rate of 100%, with 13 cases (93%) showing type 1 closure and one case with type 2 closure of the macular hole.
Conclusions: Vitrectomy with foveal sparing ILM peeling leaving only a narrow rim and ILM flap transposition over the macular hole resulted in a high macular hole closure rate.
Financial Disclosure: O. Findl is a scientific advisor for Alcon, Croma, Carl Zeiss Meditec AG, Johnson & Johnson and Merck, but has no personal interest in the products mentioned. All authors declare, that there are no conflicts of interest.
