Zofia Michalewska, Zofia Nawrocka, Jerzy Nawrocki, Poland

Purpose:
To present effects of the inverted internal limiting membrane (ILM) flap technique in full-thickness macular holes (FTMH) coexisting with drusen.

Methods:
A retrospective observational case study.19 eyes of 13 patients (mean age 68 years) were included. Vitrectomy with the inverted ILM flap technique was performed. Inclusion criteria implemented: full-thickness macular hole, drusen, vitrectomy performed and spectral domain optical coherence tomography (SD OCT) (Copernicus HR, Optopol, Poland) or swept source OCT (Triton, Topcon, Japan) before surgery, then at one week (±3 days), one month (±1 week), three (±1 month), six (±1 month), twelve (±2 months) and 18-36 months after surgery.

Main Outcome Measures:
Closure of macular hole and visual acuity at 18-36 months after vitrectomy. Results Mean minimum macular hole diameter: 493 μm (135-1052 μm). Mean maximum macular hole diameter: 1072 μm (590-1745 μm). Macular hole was closed in seventeen eyes after first surgery and in all eyes after second surgery. Improvement of visual acuity was statistically significant (P = 0.05), but there was no statistically significant correlation observed between initial macular hole diameters and final visual acuity (P > 0.1).

Conclusions:
The inverted ILM flap technique improves anatomical and functional results in eyes with coexisting drusen and FTMH. It is possible to close FTMH with coexisting neovascualr membranes. Anti- VEGF treatment might be continued after vitrectomy.

Contact Details:

Zofia Michalewska
Ophthalmic Clinic Jasne Blonia
Lodz
Poland
Cell Phone : +48694251248
Work Phone : +48694251248
Email : zosia_n@yahoo.com