Risk factors for glial cell proliferation after idiopathic macular hole repair with internal limiting membrane flap

Abstract

Abstract Background To study the influencing factors for different healing patterns of patients with idiopathic macular holes (IMH) after vitrectomy surgery performed with the internal limiting membrane (ILM) flap technique. Methods This study was a retrospective, consecutive, observational case series study. We recruited 52 IMH patients who underwent vitrectomy with the ILM flap technique. The participants were divided into 2 groups: group A (25 patients), without significant glial cell proliferation in the macular area on postoperative optical coherence tomography (OCT); and group B (27 patients), with significant glial cell proliferation. The postoperative visual acuity (VA), external limiting membrane (ELM) and ellipsoid zone (EZ) recovery characteristics were compared between the two groups. Results There were statistically significant differences in minimum linear diameter (MLD) of the macular hole and postoperative VA (p = 0.02, 2.81 E-4 respectively) between the two groups. Compared with patients in group A, patients in group B had poorer VA and EZ recovery in the first 12 months after surgery, and a longer ELM recovery period. The OCT results showed that patients in group B had more extensive ILM filling in the macular area after surgery than patients in group A. Conclusion The presence of aberrant glial cell proliferation was related to a larger MLD of the IMH, and the filling approach for the ILM during the operation was related to the postoperative healing pattern and vision acuity.

Keywords

• Idiopathic macular hole
• Internal limiting membrane flap
• Glial cell proliferation
• Vitrectomy
• Optical coherence tomography