Abstract：
BACKGROUND: We compared postoperative metamorphopsia and optical coherence tomography (OCT) findings between eyes that underwent internal limiting membrane (ILM) peeling and the inverted flap (IF) technique for macular hole (MH).
METHODS: This retrospective analysis included 64 eyes of 64 patients with idiopathic MH whose MH was closed after initial surgery. Thirty-nine patients were treated with pars plana vitrectomy (PPV) with ILM peeling, and 25 patients were treated with PPV with the IF technique. Best corrected visual acuity (BCVA), severity of metamorphopsia, and OCT images were collected before and 3, 6, and 12 months postoperatively. Based on the OCT images, the status of the external limiting membrane (ELM) and ellipsoid zone and the presence of hyperreflective plugs were assessed.
RESULTS: At baseline and 3, 6, and 12 months postoperatively, BCVA and severity of metamorphopsia were not significantly different between groups. The status of the ELM was significantly worse in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Significantly more hyperreflective plugs were observed in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Stepwise multiregression analysis revealed that hyperreflective plugs were significantly associated with the severity of metamorphopsia at 12 months postoperatively.
CONCLUSIONS: The alterations on the OCT were fewer in the ILM peeling group than in the IF group, while no significant differences were observed in postoperative severity of metamorphopsia between groups. Metamorphopsia was worse in eyes with hyperreflective plugs.
METHODS: This retrospective analysis included 64 eyes of 64 patients with idiopathic MH whose MH was closed after initial surgery. Thirty-nine patients were treated with pars plana vitrectomy (PPV) with ILM peeling, and 25 patients were treated with PPV with the IF technique. Best corrected visual acuity (BCVA), severity of metamorphopsia, and OCT images were collected before and 3, 6, and 12 months postoperatively. Based on the OCT images, the status of the external limiting membrane (ELM) and ellipsoid zone and the presence of hyperreflective plugs were assessed.
RESULTS: At baseline and 3, 6, and 12 months postoperatively, BCVA and severity of metamorphopsia were not significantly different between groups. The status of the ELM was significantly worse in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Significantly more hyperreflective plugs were observed in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Stepwise multiregression analysis revealed that hyperreflective plugs were significantly associated with the severity of metamorphopsia at 12 months postoperatively.
CONCLUSIONS: The alterations on the OCT were fewer in the ILM peeling group than in the IF group, while no significant differences were observed in postoperative severity of metamorphopsia between groups. Metamorphopsia was worse in eyes with hyperreflective plugs.
摘要：
背景：我们比较了内界膜剥离（ILM）和倒置皮瓣（IF）技术对黄斑裂孔（MH）的术后变形和光学相干断层扫描（OCT）结果。
方法：这项回顾性分析包括64例特发性MH患者的64只眼，这些患者在初次手术后关闭了MH。39例患者接受了带ILM剥离的平坦部玻璃体切除术（PPV）治疗，25例患者采用IF技术进行PPV治疗。最佳矫正视力（BCVA），变质的严重程度，术前和术后3、6和12个月收集OCT图像.根据OCT图像,评估了外界膜（ELM）和椭圆体区的状态以及高反射塞的存在。
结果：在基线和术后3、6和12个月，BCVA和变形的严重程度在组间没有显着差异。术后3个月和6个月，IF组的ELM状态明显低于ILM剥离组。术后3个月和6个月，IF组观察到的高反射栓塞明显多于ILM剥离组。逐步回归分析显示，术后12个月时，高反射塞与变形视的严重程度显着相关。
结论：ILM剥离组的OCT改变少于IF组，而两组间术后变形视严重程度无显著差异。在具有高反射塞的眼睛中，变形性视错觉更为严重。
方法：这项回顾性分析包括64例特发性MH患者的64只眼，这些患者在初次手术后关闭了MH。39例患者接受了带ILM剥离的平坦部玻璃体切除术（PPV）治疗，25例患者采用IF技术进行PPV治疗。最佳矫正视力（BCVA），变质的严重程度，术前和术后3、6和12个月收集OCT图像.根据OCT图像,评估了外界膜（ELM）和椭圆体区的状态以及高反射塞的存在。
结果：在基线和术后3、6和12个月，BCVA和变形的严重程度在组间没有显着差异。术后3个月和6个月，IF组的ELM状态明显低于ILM剥离组。术后3个月和6个月，IF组观察到的高反射栓塞明显多于ILM剥离组。逐步回归分析显示，术后12个月时，高反射塞与变形视的严重程度显着相关。
结论：ILM剥离组的OCT改变少于IF组，而两组间术后变形视严重程度无显著差异。在具有高反射塞的眼睛中，变形性视错觉更为严重。
