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Abstract：
OBJECTIVE: To examine the effects of the temporal inverted internal limiting membrane (ILM) flap technique for foveal reconstruction in patients with highly myopic macular hole-associated retinal detachment (MHRD).
METHODS: A retrospective case series analysis of four patients (four eyes) with MHRD was conducted. The foveal optical coherence tomography changes following treatment using the temporal inverted ILM flap technique were evaluated.
RESULTS: In Patient 1, the ILM bridged the macular hole and residual subretinal fluid on postoperative day 6, and complete retinal reattachment was achieved at 19 months. Patient 2 exhibited reduced retinal detachment, with visible ILM inversion and macular hole closure after 14 days. In Patient 3, macular hole closure and fovea formation had occurred by day 25, and the ILM flap was visible. At 2 months, the outer collagenous layer connection in the central fovea and recovery of the external limiting membrane and ellipsoid zone were observed. Patient 4 had a \"white hole\" MHRD, with macular hole closure achieved on postoperative day 20, albeit with a suboptimal foveal shape.
CONCLUSIONS: The temporal inverted ILM flap technique in conjunction with vitrectomy facilitates foveal reconstruction in patients with successful treatment of MHRD, and this reconstruction process can be observed by optical coherence tomography.
METHODS: A retrospective case series analysis of four patients (four eyes) with MHRD was conducted. The foveal optical coherence tomography changes following treatment using the temporal inverted ILM flap technique were evaluated.
RESULTS: In Patient 1, the ILM bridged the macular hole and residual subretinal fluid on postoperative day 6, and complete retinal reattachment was achieved at 19 months. Patient 2 exhibited reduced retinal detachment, with visible ILM inversion and macular hole closure after 14 days. In Patient 3, macular hole closure and fovea formation had occurred by day 25, and the ILM flap was visible. At 2 months, the outer collagenous layer connection in the central fovea and recovery of the external limiting membrane and ellipsoid zone were observed. Patient 4 had a \"white hole\" MHRD, with macular hole closure achieved on postoperative day 20, albeit with a suboptimal foveal shape.
CONCLUSIONS: The temporal inverted ILM flap technique in conjunction with vitrectomy facilitates foveal reconstruction in patients with successful treatment of MHRD, and this reconstruction process can be observed by optical coherence tomography.
摘要：
目的：探讨颞叶倒置内界膜（ILM）皮瓣技术在高度近视黄斑裂孔相关视网膜脱离（MHRD）患者中央凹重建中的应用效果。
方法：对4例MHRD患者（4只眼）进行回顾性病例系列分析。评估了使用颞叶倒置ILM皮瓣技术治疗后的中央凹光学相干断层扫描变化。
结果：在患者1中，ILM在术后第6天桥接了黄斑裂孔和残余的视网膜下液，并在19个月时实现了视网膜完全复位。患者2表现出减少的视网膜脱离,14天后可见ILM倒置和黄斑孔闭合。在患者3中,到第25天已经发生黄斑孔闭合和中央凹形成,并且可见ILM瓣。2个月时,观察到中央凹的外部胶原层连接以及外部限制膜和椭球区的恢复。病人4有一个“白洞”MHRD，在术后第20天实现黄斑裂孔闭合，尽管中央凹形状欠佳。
结论：在成功治疗MHRD的患者中，颞侧倒置ILM皮瓣技术结合玻璃体切除术可促进中央凹重建，这种重建过程可以通过光学相干层析成像观察到。
方法：对4例MHRD患者（4只眼）进行回顾性病例系列分析。评估了使用颞叶倒置ILM皮瓣技术治疗后的中央凹光学相干断层扫描变化。
结果：在患者1中，ILM在术后第6天桥接了黄斑裂孔和残余的视网膜下液，并在19个月时实现了视网膜完全复位。患者2表现出减少的视网膜脱离,14天后可见ILM倒置和黄斑孔闭合。在患者3中,到第25天已经发生黄斑孔闭合和中央凹形成,并且可见ILM瓣。2个月时,观察到中央凹的外部胶原层连接以及外部限制膜和椭球区的恢复。病人4有一个“白洞”MHRD，在术后第20天实现黄斑裂孔闭合，尽管中央凹形状欠佳。
结论：在成功治疗MHRD的患者中，颞侧倒置ILM皮瓣技术结合玻璃体切除术可促进中央凹重建，这种重建过程可以通过光学相干层析成像观察到。
