Anatomical outcome of temporal inverted flap technique versus conventional internal limiting membrane peeling for large macular hole treatment

Abstract

Objective To compare temporal inverted ILM flap (TIF) technique versus conventional ILM peeling (CILMP) technique in large idiopathic full-thickness macular hole (FTMH) regarding closure rate, and type of closure.Methods We conducted a randomized, interventional, prospective, comparative study. After informed consent, 40 eyes were included and were divided into 2 groups. Group 1 included 20 eyes that underwent Pars plana vitrectomy (PPV) with CILMP, and group 2 included 20 eyes that underwent PPV with the TIF technique in the period between December 2021 and July 2023. Pre and postoperative full ophthalmological assessment and OCT were done, with a follow-up period of 6 months after surgery.Results Macular hole (MH) closure was achieved in 80% of eyes in group 1 (16/20) and 90% of eyes in group 2 (18/20) after primary surgery. U-shaped foveal contour was achieved in 85%, 95%, and 100% of eyes in group 2 at 1,3 and 6 months respectively. However, it was recorded in 55% in group 1 at 1,3 and 6 months.Conclusion The MH closure rate achieved by the CILMP technique is comparable to that achieved by the TIF technique. However, the TIF technique achieves better foveal contour compared to the CILMP technique.

Keywords

• large full-thickness macular hole
• temporal flap technique
• conventional ILM peeling technique