The application of inverted internal limiting membrane flap technique in macular hole_Chinese Journal of Ocular Fundus Diseases

Authors：

CaoWei ,  HanQuanhong

Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, The Ophthalmic College of Tianjin Medical University, Tianjin 300020, China;

Corresponding author：

HanQuanhong, Email: hanquanhong126@126.com

Keywords：

Retinal perforations/surgery; Vitreoretinal surgery; Review

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.031

Video：

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Vitrectomy combined with internal limiting membrane (ILM) peeling and vitreous tamponade is a conventional method for treating macular hole (MH), but the visual acuity and MH closure rate remains to be further improved. After removal of posterior vitreous cortex, the ILM is grasped with an ILM forceps and peeled off in a circular fashion for approximately 1 disc diameters around the MH. During the circumferential peeling, the ILM is not removed completely from the retina but is left attached to the edges of the MH. The ILM was then massaged gently over the MH from all sides until the ILM became inverted and then peel all other ILM within vascular arcades. Inverted ILM flap technique is one of the important improvement methods in MH vitrectomy, especially for MH with large diameter and unhealed MH after ILM peeling. Compared with conventional vitrectomy combined with ILM peeling, inverted ILM flap technique can enhance MH closure and improve visual acuity. Due to lack of large sample observation in clinical trials of inverted ILM flap technique, we still need more cases and longer follow-up of this technology to more accurately evaluate the effectiveness and safety of this technique.

Citation： CaoWei, HanQuanhong. The application of inverted internal limiting membrane flap technique in macular hole. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 561-563. doi: 10.3760/cma.j.issn.1005-1015.2016.05.031 Copy

1.	毛新帮, 赵菊莲,游志鹏. 黄斑部疾病手术治疗的研究进展[J]. 江西医学院学报, 2009, 49(8):116-118.DOI:10.3969/j.issn.1000-2294.2009.08.046. Mao XB,Zhao JL,You ZP.Advances in surgical treatment of macular disease[J]. Acta Academiae Medicinae Jiangxi, 2009, 49(8):116-118.DOI:10.3969/j.issn.1000-2294.2009.08.046.
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3.	Kwok AK, Li WW, Pang CP, et al. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery:histology and outcome[J]. Am J Ophthalmol, 2001,132(2):178-183.
4.	黄旭东, 吴鹏. 特发性黄斑裂孔研究进展[J]. 国际眼科杂志, 2014,14(2):259-262. DOI:10.3980/j.issn.1672-5123.2014.02.16. Huang XD,Wu P. Research progress of idiopathic macular hole[J]. Int Eye Sci, 2014,14(2):259-262. DOI:10.3980/j.issn.1672-5123.2014.02.16.
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6.	贺峰, 张潇,董方田.视网膜内界膜移植治疗复发性黄斑大裂孔一例[J]. 中华眼科杂志, 2013, 49(6):551-552. DOI:10.3760/cma.j.issn.0412-4081.2013.06.016. He F,Zhang X,Dong FT. Internal limiting membrane transplantation for one case of recurrent large macular hole[J]. Chin J Ophthalmol,2013, 49(6):551-552. DOI:10.3760/cma.j.issn.0412-4081.2013.06.016.
7.	张杰, 吴鹏,黄旭东,等. 视网膜内界膜移植术在特发性黄斑裂孔手术治疗中的应用[J]. 滨州医学院学报, 2014,37(2):98-101. Zhang J,Wu P,Huang XD,et al.The short-term survey of internal limiting membrane transplantation on treating idiopathic macular hole[J]. BMU Journal, 2014,37(2):98-101.
8.	Alpatov S,Shchuko A,Malyshev V.A new method of treating macular holes[J].Eur J Ophthalmol,2007,17(2):246-252.
9.	Charles S,Randolph JC,Neekhra A,el al.Arcuate retinotomy for the repair of large macular holes[J].Ophthalmic Surg Lasers Imaging,2013, 44(1):69-72. DOI:10.3928/23258160-20121221-15.
10.	Reis R,Ferreira N,Meireles A.Management of stage Ⅳ macular holes:when standard surgery fails[J].Case Rep Ophthalmol,2012,3(2):240-250.DOI:10.1159/000342007.
11.	Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
12.	Kuriyama S, Hayashi H, Jingami Y, et al. Efficacy of inverted internal limiting membrane flap technique for the treatment of macular hole in high myopia[J]. Am J Ophthalmol, 2013,156(1):125-131.DOI:10.1016/j.ajo.2013.02.014.
13.	吴鹏, 黄旭东,孙先勇,等.内界膜剥除及其联合内界膜移植治疗特发性黄斑裂孔的疗效对比观察[J].中华眼底病杂志,2014, 30(3):253-256. Wu P,Huang XD,Sun XY,et al. Efficacy of internal limiting membrane peeling and transpIantation for the treatment of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2014, 30(3):253-256. DOI:10.3760/cma.j.issn.1005-1015.2014.03.007.
14.	Shin MK, Park KH, Park SW, et al. Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery[J]. Retina, 2014, 34(9):1905-1910. DOI:10.1097/IAE.0000000000000339.
15.	董方田, 杨治坤,邹绚. 未愈合特发性黄斑裂孔的新型手术方式:游离内界膜移植[J]. 协和医学杂志, 2013,4(4):425-428. DOI:10.3969/j.issn.1674-9081.2013.04.016. Dong FT,Yang ZK,Zou X. Free internal limiting membrane flap transplantation for unclosed idiopathic macular holes[J]. Medical Journal of Peking Union Medical College Hospital, 2013,4(4):425-428. DOI:10.3969/j.issn.1674-9081.2013.04.016.
16.	翟彦君. 黄斑裂孔视网膜脱离的手术治疗[J]. 临床眼科杂志, 2010,18(6):505-507.DOI:10.3969/j.issn.1006-8422.2010.06.010. Zhai YJ. Therapeutic efect of surgical treatment on the retinal detachment with macular hole[J]. J Clin Ophthalmol, 2010,18(6):505-507.DOI:10.3969/j.issn.1006-8422.2010.06.010.
17.	张钊镇, 张少冲. 特发性黄斑裂孔治疗新进展[J]. 国际眼科纵览,2011,35(4):277-280.DOI:10.3760/cma.j.issn.1673-5803.2011.04.012. Zhang ZT, Zhang SC. Idiopathic macular holes treatment advances[J]. Int Rev Ophthalmol, 2011,35(4):277-280.DOI:10.3760/cma.j.issn.1673-5803.2011.04.012.
18.	Hangai M,Ojima Y,Gotoh N,et al.Three-dimensional imaging of macular holes with high-speed optical coherence tomography[J]. Ophthalmology,2007,114(4):763-773.
19.	Dun Y, Vargas J, Brot N, et al. Independent roles of methionine sulfoxide reductase A in mitochondrial ATP synthesis and as antioxidant in retinal pigment epithelial cells[J]. Free Radic Biol Med,2013,65:1340-1351. DOI:10.1016/j.freeradbiomed.2013.10.006.

1. 毛新帮, 赵菊莲,游志鹏. 黄斑部疾病手术治疗的研究进展[J]. 江西医学院学报, 2009, 49(8):116-118.DOI:10.3969/j.issn.1000-2294.2009.08.046. Mao XB,Zhao JL,You ZP.Advances in surgical treatment of macular disease[J]. Acta Academiae Medicinae Jiangxi, 2009, 49(8):116-118.DOI:10.3969/j.issn.1000-2294.2009.08.046.
2. Gass JD. Idiopathic senile macular hole:its early stages and pathogenesis[J]. Arch Ophthatmol, 1988,106(5):629-639.
3. Kwok AK, Li WW, Pang CP, et al. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery:histology and outcome[J]. Am J Ophthalmol, 2001,132(2):178-183.
4. 黄旭东, 吴鹏. 特发性黄斑裂孔研究进展[J]. 国际眼科杂志, 2014,14(2):259-262. DOI:10.3980/j.issn.1672-5123.2014.02.16. Huang XD,Wu P. Research progress of idiopathic macular hole[J]. Int Eye Sci, 2014,14(2):259-262. DOI:10.3980/j.issn.1672-5123.2014.02.16.
5. Michalewska Z, Michalewski J, Cisiecki S, et al. Correlation between foveal structure and visual outcome following macular hole surgery:a spectral optical coherence tomography study[J]. Graefe's Arch Clin Exp Ophthalmol, 2008,246(6):823-830. DOI:10.1007/s00417-007-0764-5.
6. 贺峰, 张潇,董方田.视网膜内界膜移植治疗复发性黄斑大裂孔一例[J]. 中华眼科杂志, 2013, 49(6):551-552. DOI:10.3760/cma.j.issn.0412-4081.2013.06.016. He F,Zhang X,Dong FT. Internal limiting membrane transplantation for one case of recurrent large macular hole[J]. Chin J Ophthalmol,2013, 49(6):551-552. DOI:10.3760/cma.j.issn.0412-4081.2013.06.016.
7. 张杰, 吴鹏,黄旭东,等. 视网膜内界膜移植术在特发性黄斑裂孔手术治疗中的应用[J]. 滨州医学院学报, 2014,37(2):98-101. Zhang J,Wu P,Huang XD,et al.The short-term survey of internal limiting membrane transplantation on treating idiopathic macular hole[J]. BMU Journal, 2014,37(2):98-101.
8. Alpatov S,Shchuko A,Malyshev V.A new method of treating macular holes[J].Eur J Ophthalmol,2007,17(2):246-252.
9. Charles S,Randolph JC,Neekhra A,el al.Arcuate retinotomy for the repair of large macular holes[J].Ophthalmic Surg Lasers Imaging,2013, 44(1):69-72. DOI:10.3928/23258160-20121221-15.
10. Reis R,Ferreira N,Meireles A.Management of stage Ⅳ macular holes:when standard surgery fails[J].Case Rep Ophthalmol,2012,3(2):240-250.DOI:10.1159/000342007.
11. Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
12. Kuriyama S, Hayashi H, Jingami Y, et al. Efficacy of inverted internal limiting membrane flap technique for the treatment of macular hole in high myopia[J]. Am J Ophthalmol, 2013,156(1):125-131.DOI:10.1016/j.ajo.2013.02.014.
13. 吴鹏, 黄旭东,孙先勇,等.内界膜剥除及其联合内界膜移植治疗特发性黄斑裂孔的疗效对比观察[J].中华眼底病杂志,2014, 30(3):253-256. Wu P,Huang XD,Sun XY,et al. Efficacy of internal limiting membrane peeling and transpIantation for the treatment of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 2014, 30(3):253-256. DOI:10.3760/cma.j.issn.1005-1015.2014.03.007.
14. Shin MK, Park KH, Park SW, et al. Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery[J]. Retina, 2014, 34(9):1905-1910. DOI:10.1097/IAE.0000000000000339.
15. 董方田, 杨治坤,邹绚. 未愈合特发性黄斑裂孔的新型手术方式:游离内界膜移植[J]. 协和医学杂志, 2013,4(4):425-428. DOI:10.3969/j.issn.1674-9081.2013.04.016. Dong FT,Yang ZK,Zou X. Free internal limiting membrane flap transplantation for unclosed idiopathic macular holes[J]. Medical Journal of Peking Union Medical College Hospital, 2013,4(4):425-428. DOI:10.3969/j.issn.1674-9081.2013.04.016.
16. 翟彦君. 黄斑裂孔视网膜脱离的手术治疗[J]. 临床眼科杂志, 2010,18(6):505-507.DOI:10.3969/j.issn.1006-8422.2010.06.010. Zhai YJ. Therapeutic efect of surgical treatment on the retinal detachment with macular hole[J]. J Clin Ophthalmol, 2010,18(6):505-507.DOI:10.3969/j.issn.1006-8422.2010.06.010.
17. 张钊镇, 张少冲. 特发性黄斑裂孔治疗新进展[J]. 国际眼科纵览,2011,35(4):277-280.DOI:10.3760/cma.j.issn.1673-5803.2011.04.012. Zhang ZT, Zhang SC. Idiopathic macular holes treatment advances[J]. Int Rev Ophthalmol, 2011,35(4):277-280.DOI:10.3760/cma.j.issn.1673-5803.2011.04.012.
18. Hangai M,Ojima Y,Gotoh N,et al.Three-dimensional imaging of macular holes with high-speed optical coherence tomography[J]. Ophthalmology,2007,114(4):763-773.
19. Dun Y, Vargas J, Brot N, et al. Independent roles of methionine sulfoxide reductase A in mitochondrial ATP synthesis and as antioxidant in retinal pigment epithelial cells[J]. Free Radic Biol Med,2013,65:1340-1351. DOI:10.1016/j.freeradbiomed.2013.10.006.

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The application of inverted internal limiting membrane flap technique in macular hole

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