Guoji Yanke Zazhi (Mar 2022)
Clinical observation of different internal limiting membrane surgeries combined with sterile air tamponade in the treatment of idiopathic macular hole
Abstract
AIM: To observe the difference of curative effect between internal limiting membrane(ILM)inversion and insertion and ILM peeling and to analyze the influence of different surgical methods on the morphology of hiatus healing.METHODS: A retrospective analysis of the clinical data of 22 patients with macular hole, who received vitrectomy in the First People's Hospital of Zunyi City from June 2017 to June 2020. According to the surgical methods, they were divided into 8 cases and 8 eyes in the ILM peeling group and 14 cases and 14 eyes in the ILM inversion covering group. The two groups of patients underwent best corrected visual acuity(BCVA)test, non-contact intraocular pressure and optical coherence tomography(OCT)examination before and 1wk, 1, and 3mo after operation were analysed. RESULTS: The macular hole closure rate in the ILM peeling group was 75%, and the hole closure rate in the ILM inversion and insertion group was 93%. There was no statistically significant difference in the hole closure rate between the two groups(P=0.527). The trends of BCVA over time in the two groups were similar, but there were differences in time(Ftime=18.426, Ptime<0.001)and no difference between groups and interactions(Fbetween groups=1.319, Pbetween groups=0.289; Fbetween groups×time=1.658, Pbetween groups×time=0.211). The BCVA of the two groups was statistically significant 1wk after operation compared with that before operation(t= -2.200, -3.092; all P<0.05); The BCVA of the ILM inversion and insertion group was improved 3mo after operation compared with that before operation, and the difference in the group was statistically significant(t=2.503, P=0.019). There was no difference in overall foveal thickness between the two groups after surgery(Ftime=1.054, Ptime=0.346; Fbetween groups=0.110, Pbetween groups=0.750; Fbetween groups×time=2.391, Pbetween groups×time=0.152).CONCLUSION: Both ILM inversion and insertion and ILM peeling can effectively increase the rate of macular hole closure. The macular structure healing after the ILM inversion and insertion is better, and the postoperative visual function improvement is more satisfactory.
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