Abstract：
OBJECTIVE: To determine and compare the efficacy of a surgical internal limiting membrane (ILM) flap technique with the traditional ILM peel on long-term visual and anatomical outcomes for large (>400 µm) full-thickness macular holes.
METHODS: From October 2016 to July 2022, patients undergoing initial full-thickness macular hole repair with the ILM flap or ILM peel technique were reviewed. Final outcomes were recorded and based on size in microns: 401 to 800, 801 to 1,200, and >1,200.
RESULTS: Patients treated with ILM flap (n = 52, 94.2% closure rate) or ILM peel (n = 407, 93.6% closure rate) were followed with a mean follow-up time of 15.0 ± 10.2 and 20.0 ± 13.4 months, respectively. Success rates for ILM flaps and ILM peels were compared for full-thickness macular holes of 401 to 800 (100%, 95.8%, P = 0.39), 801 to 1,200 (95%, 93%, P = 0.74), and >1,200 (86.7%, 86.7%, P = 1.0) µm. Mean best-recorded logarithm of the minimal angle of resolution visual acuity for ILM flaps and ILM peels, respectively, was 1.02 ± 0.46 and 0.87 ± 0.47 preoperatively, with follow-up acuity of 0.48 ± 0.32 (P < 0.03) and 0.39 ± 0.42 (P < 0.01) at Year 3.
CONCLUSIONS: Both techniques provide a similar anatomical closure rate and functional improvement in vision. Comparisons should be cautiously made based on difference in preoperative hole size.
METHODS: From October 2016 to July 2022, patients undergoing initial full-thickness macular hole repair with the ILM flap or ILM peel technique were reviewed. Final outcomes were recorded and based on size in microns: 401 to 800, 801 to 1,200, and >1,200.
RESULTS: Patients treated with ILM flap (n = 52, 94.2% closure rate) or ILM peel (n = 407, 93.6% closure rate) were followed with a mean follow-up time of 15.0 ± 10.2 and 20.0 ± 13.4 months, respectively. Success rates for ILM flaps and ILM peels were compared for full-thickness macular holes of 401 to 800 (100%, 95.8%, P = 0.39), 801 to 1,200 (95%, 93%, P = 0.74), and >1,200 (86.7%, 86.7%, P = 1.0) µm. Mean best-recorded logarithm of the minimal angle of resolution visual acuity for ILM flaps and ILM peels, respectively, was 1.02 ± 0.46 and 0.87 ± 0.47 preoperatively, with follow-up acuity of 0.48 ± 0.32 (P < 0.03) and 0.39 ± 0.42 (P < 0.01) at Year 3.
CONCLUSIONS: Both techniques provide a similar anatomical closure rate and functional improvement in vision. Comparisons should be cautiously made based on difference in preoperative hole size.
摘要：
目的：确定并比较手术内界膜（ILM）皮瓣技术与传统ILM剥离对大型（>400µm）全厚度黄斑裂孔的长期视觉和解剖学结果的疗效。
方法：从2016年10月至2022年7月，对使用ILM皮瓣或ILM剥离技术进行初始全层黄斑裂孔修复的患者进行回顾。记录最终结果并基于微米尺寸:401至800、801至1,200和>1,200。
结果：接受ILM皮瓣（n=52，闭合率为94.2%）或ILM剥离（n=407，闭合率为93.6%）治疗的患者，平均随访时间为15.0±10.2和20.0±13.4个月，分别。ILM皮瓣和ILM剥离的成功率比较了401至800的全厚度黄斑孔（100％，95.8%,P=0.39),801至1200(95%，93%,P=0.74),和>1200（86.7%，86.7%,P=1.0)µm。ILM皮瓣和ILM剥离的最小分辨率视敏度角度的平均最佳记录对数，分别,术前分别为1.02±0.46和0.87±0.47，随访3年视力分别为0.48±0.32(P<0.03)和0.39±0.42(P<0.01)。
结论：两种技术均提供相似的解剖闭合率和视力功能改善。应根据术前孔大小的差异谨慎进行比较。
方法：从2016年10月至2022年7月，对使用ILM皮瓣或ILM剥离技术进行初始全层黄斑裂孔修复的患者进行回顾。记录最终结果并基于微米尺寸:401至800、801至1,200和>1,200。
结果：接受ILM皮瓣（n=52，闭合率为94.2%）或ILM剥离（n=407，闭合率为93.6%）治疗的患者，平均随访时间为15.0±10.2和20.0±13.4个月，分别。ILM皮瓣和ILM剥离的成功率比较了401至800的全厚度黄斑孔（100％，95.8%,P=0.39),801至1200(95%，93%,P=0.74),和>1200（86.7%，86.7%,P=1.0)µm。ILM皮瓣和ILM剥离的最小分辨率视敏度角度的平均最佳记录对数，分别,术前分别为1.02±0.46和0.87±0.47，随访3年视力分别为0.48±0.32(P<0.03)和0.39±0.42(P<0.01)。
结论：两种技术均提供相似的解剖闭合率和视力功能改善。应根据术前孔大小的差异谨慎进行比较。
