Advertisement

International Ophthalmology

, Volume 39, Issue 4, pp 929–934 | Cite as

Intraoperative optical coherence tomography in the full-thickness macular hole surgery with internal limiting membrane inverted flap placement

  • Enrico BorrelliEmail author
  • Michele Palmieri
  • Agbeanda Aharrh-Gnama
  • Vincenzo Ciciarelli
  • Rodolfo Mastropasqua
  • Paolo Carpineto
Case Report

Abstract

Purpose

To describe the helpfulness of using intraoperative optical coherence tomography (OCT) during surgery for full-thickness macular hole (FTMH).

Observations

This observational case series identifies three patients with FTMH who were treated with vitrectomy, internal limiting membrane (ILM) peel with inverted ILM flap, which was tucked into the MH, and air with 18% Sulfur Hexafluoride (SF6) gas tamponade. Intraoperative OCT was used to confirm positioning of the ILM flap, even after complete air-fluid exchange. The patients were followed for three months after surgery and all reached a good morphological and functional outcome.

Conclusions

If confirmed by a prospective longitudinal study, the intraoperative OCT might become an important tool in assisting FTMH surgery.

Keywords

Intraoperative OCT Full-thickness macular hole Vitrectomy ILM peeling ILM flap 

Notes

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Lister W (1924) Holes in the retina and their clinical significance. Br J Ophthalmol 8:i4–i20CrossRefGoogle Scholar
  2. 2.
    Steel DHW, Lotery AJ (2013) Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment. Eye (Lond) 27(Suppl 1):S1–S21CrossRefGoogle Scholar
  3. 3.
    Spiteri Cornish K, Lois N, Scott NW et al (2014) Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole. Ophthalmology 121:649–655CrossRefGoogle Scholar
  4. 4.
    Michalewska Z, Michalewski J, Adelman RA, Nawrocki J (2010) Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology 117:2018–2025CrossRefGoogle Scholar
  5. 5.
    Hee MR, Puliafito CA, Wong C et al (1995) Optical coherence tomography of macular holes. Ophthalmology 102:748–756CrossRefGoogle Scholar
  6. 6.
    Smiddy WE, Flynn HW (2004) Pathogenesis of macular holes and therapeutic implications. Am J Ophthalmol 137:525–537CrossRefGoogle Scholar
  7. 7.
    Gaudric A, Haouchine B, Massin P et al (1999) Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol (Chicago, Ill 1960) 117:744–751CrossRefGoogle Scholar
  8. 8.
    Ehlers JP, Tam T, Kaiser PK et al (2014) Utility of intraoperative optical coherence tomography during vitrectomy surgery for vitreomacular traction syndrome. Retina 34:1341–1346CrossRefGoogle Scholar
  9. 9.
    Lois N, Burr J, Norrie J et al (2011) Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole: a pragmatic randomized controlled trial. Invest Opthalmology Vis Sci 52:1586CrossRefGoogle Scholar
  10. 10.
    Morizane Y, Shiraga F, Kimura S et al (2014) Autologous transplantation of the internal limiting membrane for refractory macular holes. Am J Ophthalmol 157(861–869):e1Google Scholar
  11. 11.
    Lai MM, Williams GA (2007) Anatomical and visual outcomes of idiopathic macular hole surgery with internal limiting membrane removal using low-concentration indocyanine green. Retina 27:477–482CrossRefGoogle Scholar
  12. 12.
    Kelly NE, Wendel RT (1991) Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol (Chicago, Ill 1960) 109:654–659CrossRefGoogle Scholar
  13. 13.
    Lois N, Burr J, Norrie J et al (2011) Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole: a pragmatic randomized controlled trial. Invest Ophthalmol Vis Sci 52:1586–1592CrossRefGoogle Scholar
  14. 14.
    Casini G, Mura M, Figus M et al (2017) Inverted internal limiting membrane flap technique for macular hole surgery without extra manipulation of the flap. Retina 37(11):2138–2144CrossRefGoogle Scholar
  15. 15.
    Hayashi A, Yagou T, Nakamura T et al (2011) Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography. Case Rep Ophthalmol 2:149–154CrossRefGoogle Scholar
  16. 16.
    Ray R, Barañano DE, Fortun JA et al (2011) Intraoperative microscope-mounted spectral domain optical coherence tomography for evaluation of retinal anatomy during macular surgery. Ophthalmology 118:2212–2217CrossRefGoogle Scholar
  17. 17.
    Ehlers JP, Xu D, Kaiser PK et al (2014) Intrasurgical dynamics of macular hole surgery: an assessment of surgery-induced ultrastructural alterations with intraoperative optical coherence tomography. Retina 34:213–221CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Ophthalmology Clinic, Department of Medicine and Science of AgeingUniversity G. D’Annunzio Chieti-PescaraChietiItaly
  2. 2.Ophthalmology ClinicUniversity of MarcheAnconaItaly

Personalised recommendations