[Anatomical and functional results of macular hole surgery using a temporal inverted internal limiting membrane flap. Experience with 24 cases]. / Résultats anatomiques et fonctionnels de la chirurgie du trou maculaire avec positionnement d'un volet de membrane limitante interne. Retour d'expérience sur 24 cas.

PURPOSE: To evaluate the anatomical and functional outcomes of macular hole (MH) surgery with a temporal inverted internal limiting membrane (ILM) flap technique. METHODS: Monocentric retrospective study of 24 patients who were operated on for macular hole between March 2014 and April 2017 at Nancy University Hospital. All patients underwent pars plana vitrectomy with the inverted ILM flap technique. ILM peeling was restricted to the temporal side of the fovea, and the macular hole was then covered with the ILM flap, followed by SF6 tamponnade and first day face-down positioning. The main outcome measures included macular hole closure rate and visual acuity at 1 month postoperatively. RESULTS: Eight men and 16 women of mean age 67.0±5.4 years were included. The mean axial length was 23.5±1.2mm. The mean diameter of the MH was 362±123µm. Closure of the MH was achieved in 23 of 24 eyes (95.8%) after one surgery. The mean BVCA improved significantly from 0.71±0.20 logMar to 0.29±0.22 logMar (P<0.001) at 1 month postoperatively, for a gain of 0.42±0.24 logMar. CONCLUSION: Macular hole surgery with the inverted ILM flap technique results in good anatomical and functional outcomes, comparable to those obtained with the classic technique with complete ILM peeling.

[Anatomical and functional results of macular hole surgery with internal limiting membrane peeling after 10-year follow-up]. / Résultats anatomiques et fonctionnels de la chirurgie du trou maculaire avec pelage de membrane limitante interne après suivi de 10 ans.

PURPOSE: To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10 years follow-up. METHODS: Monocentric retrospective study of patients who had undergone macular hole surgery between 2003 and 2005 in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. RESULTS: Four men and six women with mean age of 64±8 years were included. The mean diameter of the MH was 395±133µm. The mean best corrected visual acuity improved significantly from 0.90±0.22 logMAR to 0.14±0.14 logMAR after 10 years with a satisfactory quality of life in 90 % of patients. The integrity of the IS/OS layer was preserved in 9 eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8 eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. CONCLUSION: Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8 ETDRS lines and persistent improvement in quality of life after a 10-year follow-up.