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Vitrectomy with internal limiting membrane peeling versus its flap insertion for macular hole in high myopia: a Meta-analysis

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International Journal of Ophthalmology(English edition) 2020年第1期13卷 141-148页

作者： Ya-Jun Wu Jie Rao Kang-Rui Wu Na Wu Yi Cheng Xiao-Xuan Xu Li Yan Yi Shao Yu Tian Xiao-Rong Wu Department of Ophthalmology the First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina Department of Ophthalmology the Second Xiangya HospitalCentral South UniversityChangsha 410008Hunan ProvinceChina

AIM: To compare the anatomic and functional outcomes between vitrectomy with internal limiting membrane(ILM) peeling and internal ILM flap insertion technique for high myopia macular hole(MH).METHODS: Pub Med, Cochrane Library, EMBASE, and CNKI were systematically searched, and all studies involved MH were included. The closure rate of MH and the postoperative best-corrected visual acuity(BCVA) at 6 mo after the initial surgery were the primary measures. All statistical tests were performed in Review Manager ***: Five studies that included 151 eyes of 151 patients were finally included, all of which were retrospectively comparative studies. Between the pars plana vitrectomy(PPV) with ILM peeling surgery and the ILM insertion technique, the latter had significantly better efficacy with respect to the closure rate of MH(OR=21.32, 95%CI=7.25-62.67, P<0.001);However, regarding BCVA at 6 mo after the initial surgery in MH, there was no statistical significance between the groups(OR=-0.04, 95%CI=-0.22-0.14, P=0.66). In addition, regarding the rate of retinal reattachment after the initial surgery, the two different methods were not significantly different(OR=2.22, 95%CI=0.34-14.32, P=0.4).CONCLUSION: Both ILM peeling and ILM insertion technique could significantly improve anatomic outcomes of MH in high myopia with or without retinal detachment(RD), and anatomic outcomes are more effective. However, there is no statistical significance in BCVA at 6 mo after the initial surgery in MH, or in the rate of retinal reattachment after the first surgery, between the two methods.

关键词： macular hole high myopia best-corrected visual acuity retinal attachment Meta-analysis

Internal limiting membrane flap technique in macular hole surgery

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International Journal of Ophthalmology(English edition) 2020年第5期13卷 822-831页

作者： Qian Xu Jie Luan School of Medicine Southeast UniversityNanjing 210009Jiangsu ProvinceChina Department of Ophthalmology Zhongda HospitalSoutheast UniversityNanjing 210009Jiangsu ProvinceChina

Vitrectomy combined with internal limiting membrane(ILM)peeling is popular for the treatment of macular hole(MH).However,the improvements of MH closure rate and postoperative visual acuity are not satisfactory especially in large and refractory ***,the ILM flap technique has gradually been applied for the treatment of MH and achieved high MH closure *** ILM flap technique has many variations,including the difference of the size,shape,number,and manner in which the flaps put on the *** ILM flap technique also has some auxiliary means including perfluoro-n-octane(PFO),dye,autologous blood and adhesive *** is controversy about the effects between several technique variations of ILM flap,and it needs to be explored in the future.

关键词： internal limiting membrane flap macular hole internal limiting membrane peeling

Covering corneal stromal lenticule for macular hole in pathological myopia

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International Journal of Ophthalmology(English edition) 2024年第9期17卷 1675-1680页

作者： Zi-Yan Tang Gang Qiao Xiao-Juan Zhang Li-Jun Xie Qiang-Xing Zou Chun-Mei He Long Zhao Hua-Qing Yang Yu Quan Kui Cao Hui Jiang Yu-Kun He Wanjiang Eye Hospital of Mianyang Mianyang 621000Sichuan ProvinceChina

AIM:To evaluate the clinical effect of a new surgery technique(covering corneal stromal lenticule,CSL)for macular hole(MH)in pathological ***:This was a prospective non-randomized series case *** eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment(MHRD)were included in this *** cases were treated with 25-gauge pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,covering CSL and C_(3)F_(8) gas *** cases were followed for 6mo,and the best-corrected visual acuity(BCVA),healing status of MH,the reattached rate of retinal detachment(RD),and reoperation rate were ***:All cases were successfully performed the surgery and the postoperative follow-up was *** surgery,MHs were healed in all 14 eyes(100%,14/14)after assessed by optical coherence *** reattachment of retina was achieved in all 6 eyes(100%,6/6)with *** was improved in 12 eyes(85.71%,12/14),and had no significant change in 2 eyes(14.29%,2/14).The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR(F=10.46,P<0.01).No serious complications occurred in all ***:The new surgery technique(covering CSL)has high reattached rate of RD and high healing rate of MH in pathological myopia in the preliminary *** it can effectively improve the visual function of *** new technique offers meaningful new ideas for treating refractory MH in pathological myopia.

关键词： corneal stromal lenticule macular hole pathological myopia

Amniotic membrane for covering high myopic macular hole associated with retinal detachment following failed primary surgery

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International Journal of Ophthalmology(English edition) 2022年第5期15卷 760-765页

作者： Gang Qiao Xiao-Juan Zhang Zi-Yan Tang Qiang-Xing Zou Chun-Mei He Xian-Ming Lei Long Zhao Yu Quan Hua-Qing Yang Kui Cao Wan-Jiang Dong Wanjiang Eye Hospital of Mianyang MianyangSichuan ProvinceChina

AIM:To evaluate the therapeutic effect of amniotic membrane(AM)for covering high myopic macular hole associated with retinal detachment following failed primary ***:Seventeen eyes of 17 patients whose axial length was more than 29 mm suffered from macular hole(MH)or MH associated with retinal detachment(RD),and had previously surgery of pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling and silicone oil(SO)*** a year after the surgery,optical coherence tomography(OCT)showed that MH did not heal in all 17 eyes and RD was still maintained in 13 eyes of these 17 *** performed SO removal combined with AM covering on macular area and C3 F8 tamponade,and phacoemulsification combined with intraocular lens implantation simultaneously cataract *** followed up these patients for one ***:In all 17 eyes,SO was removed successfully,MHs were healed and RDs were *** eye(5.89%,1/17)had AM shifted half a month after surgery and underwent a second surgery to adjust the position of the AM and supplement C3 *** surgery,the visual acuity(VA)improved in 15 eyes(88.24%,15/17),no change in two eyes(11.76%,2/17).No serious complications occurred in all ***:AM covering is helpful to rescue the previous failure surgery of high myopic MH.

关键词： amniotic membrane high myopia macular hole retinal detachment

Vitreo-retinal interface changes on optical coherence tomography in the fellow eyes of patients with macular hole

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International Journal of Ophthalmology(English edition) 2013年第4期6卷 526-530页

作者： Ajit Babu Majji Jay Kumar Chhablani Bupesh Bagga Smt.Kanuri Santhamma Retina Vitreous Centre L.V.Prasad Eye InstituteKallam Anji Reddy CampusL.V.Prasad MargBanjara HillsHyderabad 500034India

AIM:To study the vitreo-retinal interface and macular changes on optical coherence tomography(OCT) in the fellow eyes of patients with macular hole.·METHODS:Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated *** details,best-corrected visual acuity and vitreo-retinal interface,and macular changes of the fellow eye on OCT were studied.·RESULTS:Seventy patients underwent OCT of both eyes during the study *** average age group was 61.96 years and 35(50%) were *** the fellow eyes,normal foveal contour was noted in 36(51.4%) eyes and 34(48.6%) eyes were observed to have vitreo-retinal interface *** them,13(18.6%) eyes had some stage of full thickness macular hole and 21(30.0%) eyes had interface *** was no statistical correlation between involved eye lesions(P =0.64) or visual acuity(P =0.55) as predictors of development of either fellow eye lesions or poor visual acuity.·CONCLUSION:There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular *** should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes,which may require an early intervention.

关键词： macular hole fellow eye optical coherence tomography vitreo-retinal interface

Vitrectomy with residual internal limiting membrane covering and autologous blood for a secondary macular hole:A case report

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World Journal of Clinical Cases 2022年第2期10卷 671-676页

作者： Huang-Fang Ying Shuang-Qing Wu Wei-Ping Hu Li-Yang Ni Zi-Long Zhang Yong-Gen Xu Department of Ophthalmology Affiliated Hospital of Shaoxing UniversityShaoxing 312000Zhejiang ProvinceChina Department of Ophthalmology Zhejiang Provincial Integrated Chinese and Western Medicine HospitalHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Myopic foveoschisis(MF)is a common complication of pathological myopia.A macular hole(MH)usually results from the natural progression of MF and is a common complication of *** combined with residual internal limiting membrane(ILM)covering and autologous blood was effective for closing a secondary *** SUMMARY A 52-year-old woman presented to our clinic with a complaint of blurred vision in the right eye for 7 *** best corrected visual acuity(BCVA)was 20/100,axial length was 25.79 mm and standard equivalent refractive error was-10.5 *** optical coherence tomography revealed foveoschisis in the right *** with fovea-sparing ILM peeling was *** MH developed and gradually expanded 5 mo after the initial *** with residual ILM covering and autologous blood was *** MH closed 3 wk after the second *** Fovea-sparing ILM peeling can provide residual ILM for the treatment of MH secondary to vitrectomy for *** combined with residual ILM covering and autologous blood is effective for closing secondary MH and improving BCVA.

关键词： Vitrectomy Internal limiting membrane Autologous blood macular hole Myopic foveoschisis Case report

Characteristics of macular microvasculature before and after idiopathic macular hole surgery

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International Journal of Ophthalmology(English edition) 2022年第1期15卷 98-105页

作者： Dan Cheng Ji-Wei Tao Xue-Ting Yu Yi-Qi Chen Mei-Xiao Shen Min-Hui Wu Jia-Feng Yu Heng-Li Lian Zhe Lu Li-Jun Shen The Affiliated Eye Hospital of Wenzhou Medical University Hangzhou 310000Zhejiang ProvinceChina

AIM:To evaluate the macular microvasculature before and after surgery for idiopathic macular hole(MH)and the association of preoperative vascular parameters with postoperative recovery of visual acuity and ***:Twenty eyes from 20 patients with idiopathic MH were *** coherence tomography angiography(OCTA)images were obtained before,2 wk,1,and 3 mo after vitrectomy with internal limiting membrane *** foveal avascular zone(FAZ)area and perimeter and regional vessel density(VD)in both layers were compared according to the 3-month best-corrected visual acuity(BCVA).RESULTS:The BCVA improved from 0.98±0.59(log MAR,Snellen 20/200)preoperatively to 0.30±0.25(Snellen 20/40)at 3 mo *** preoperative deep VD was smaller and the FAZ perimeter was larger in the 3-month BCVA<20/32 group(all P<0.05).A significant reduction was observed in FAZ parameters and all VDs 2 wk *** for deep perifoveal VD,all VDs recovered only to their preoperative *** postoperative FAZ parameters were lower during *** in preoperative deep VDs were correlated with worse postoperative BCVA(Pearson’s r=-0.667 and-0.619,respectively).A larger FAZ perimeter(Spearman’s r=-0.524)and a lower deep perifoveal VD preoperatively(Pearson’s r=0.486)were associated with lower healing ***:The status of the deep vasculature may be an indicator of visual acuity in patients with a closed *** for the deep perifoveal region,VD recovers only to preoperative levels.

关键词： macular microvasculature macular hole vitreoretinal surgery optical coherence tomography angiography

Episcleral macular buckling for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole

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International Journal of Ophthalmology(English edition) 2013年第2期6卷 165-168页

作者： Jiao Tian Luo-Sheng Tang Xiao-Jian Guo Yong-Heng Luo Department of Ophthalmology and Eye Disease Research Centre the Second Xiangya Hospital Central South University

AIM: To evaluate anatomical and visual outcomes of episcleral macular buckling (EMB) for posterior retinal detachment in silicone oil filled eyes associated with myopic macular ***: Five cases of EMB for initial failure of retinal reattachment after internal limiting membrane (ILM) peeling and silicone oil tamponade caused by myopic macular hole were retrospectively reviewed. A silicone sponge sutured directly across the macular region was performed on the silicone oil filled eyes. Silicone oil was removed no sooner than 1 month post- EMB. The duration of follow -up time after removal of silicone oil was more than 3 ***: Retinas of five eyes were all reattached at the last follow-up. The postoperative vision ranged from counting fingers to ***: Anatomical results improved after EBM for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole, which was not evident for visual outcome.

关键词： episcleral macular buckling myopia macular hole retinal detachment silicone oil tamponade

Treatment of refractory giant macular hole by vitrectomy with internal limiting membrane transplantation and autologous blood

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International Journal of Ophthalmology(English edition) 2018年第5期11卷 818-822页

作者： Wen-Juan Lyu Lei-Bing Ji Yun Xiao Yin-Bo Fan Xue-Hong Cai Department of Ophthalmology No.474 Hospital of the People’s Liberation Army(PLA)

AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular ***：Thirty-seven eyes with giant macular hole of the smallest hole diameter 〉700 μm,the maximum diameter of the substrate 〉1000 μm and hole formation factor 〈0.6 underwent surgical *** patients were randomly divided into two *** eyes with surgical flip of the internal limiting membrane in group A,18 eyes with internal limiting membrane transplantation in group B who underwent the tamponade of internal limiting membrane into the hole,autologous plasma was used to seal the *** patients were followed up for 3 mo,optical coherence tomography and best corrected visual acuity（BCVA） were recorded before and after operation,and the results were statistically ***：At 3 mo after operation,BCVA of the two groups was significantly improved compared with that before operation（tA=4.192,tB=4.374,P〈0.05）.But there was no significant difference in visual acuity between the two groups（χ^2=0.128,P〉0.05）.At 3 mo after operation,the closure rate of group A was 68.4%,and 100% in group B.（χ^2=5.628,P〈0.05）.The defect diameter of inner segment/outer segment at 3 mo after the operation was significantly lower than that before operation（tA=12.287,tB=15.481,P〈0.05）,and the difference was statistically significant（t=2.552,P〈0.05）.CONCLUSION：Internal limiting membrane transplantation combined with autologous whole blood can improve the postoperative closure rate of the refractory large aperture,and can effectively improve the postoperative visual acuity.

关键词： internal limiting membrane transplantation autologous blood refractory macular hole