Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

• Published in: Eye (London) Vol. 37; no. 13; pp. 2730 - 2735
• Main Authors: Zhao, Xiujuan, Song, Huiying, Tanumiharjo, Silvia, Wang, Yanbing, Chen, Yuqing, Chen, Shida, Huang, Xia, Liu, Bingqian, Lian, Ping, Lu, Lin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2023; Nature Publishing Group
• Subjects: 692/308/409; 692/699/3161; Acuity; Laboratory Medicine; Medicine; Medicine & Public Health; Myopia; Ophthalmology; Pharmaceutical Sciences/Technology; Retina; Surgery; Surgical Oncology
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-023-02406-1

Purpose To compare the efficacy of macular buckling (MB) alone against a combined internal limiting membrane (ILM) inversion flap for full-thickness macular hole (FTMH)-associated macular detachment (MD) in patients with high myopia. Methods This was a prospective interventional case series of patients with high myopia surgically treated with MB alone or combined with an inverted ILM flap for FTMH- associated MD. Best-corrected visual acuity (BCVA) at the 24-month postoperative follow-up, rate of initial retinal reattachment and macular hole closure were measured. Results A total of 62 eyes from 62 participants (33 in the MB group, 29 in the combination group) were studied. Postoperative BCVA improved significantly in both the combination group ( P  < 0.001) and the MB group ( P  = 0.027). The postoperative BCVA at 12 months ( P  = 0.021) and 24 months ( P  = 0.041) was significantly better in the combination group than in the MB group. The postoperative BCVA was not significantly different between the eyes with closed and unclosed MH at each follow-up time point ( P  > 0.05). In the combination group, we observed earlier retinal reattachment and closure of the MH as well as a higher rate of MH closure (82.8% vs. 66.7%) than in the MB group, although this difference was insignificant ( P  = 0.248). Conclusion MB combined with the ILM flap inversion technique achieved better postoperative BCVA and a higher success rate of MH closure than MB alone. We believe that combination surgery should be preferentially recommended.