Journal Article

Surgical outcomes of petalloid multilayered inverted internal limiting membrane flaps in extra-large macular holes

Ayachit, Apoorva, Vibhute, Giriraj, Yadav, Nishita, Ayachit, Guruprasad, Joshi, Madan, Joshi, Shrinivas

2024

Overview

To analyze the surgical outcomes of petalloid multilayered inverted internal limiting flap using perfluorocarbon liquid (PFCL) in extra-large macular holes (MHs) (minimum linear diameter >550 µm and basal diameter [BD] >1000 µm). This was a prospective interventional series of 103 eyes of 99 patients with extra-large MHs which were treated with 25-gauge pars plana vitrectomy, petalloid multilayered inverted internal limiting membrane flaps under PFCL and 15% perfluoropropane (C3F8) gas tamponade. Intraoperative optical coherence tomography (i-OCT) was used to confirm correct positioning of flaps. Follow-up was at 1 week, 1 month, and 3 months postoperatively. Mean age of patients was 58.282 ± 16.3 years. Mean preoperative best corrected visual acuity (BCVA) was logarithm of minimum angle of resolution (logMAR) 1.206 ± 0.384, and the value at the third month was logMAR 0.793 ± 0.337. Mean minimum linear diameter (MLD) was 711.96 ± 270.744 µm. MLD ranged from 557µm (minimum MLD) to 2657 µm (maximum MLD). Mean BD was 1301.165 ± 425.914 µm. Type 1 closure was seen in 92.2% eyes, 5.8% eyes had type 2 closure, and 1.9% eyes had type 3 closure. Eyes with both type 1 closure (P = 0.001) and type 2 closure (P = 0.009) showed a significant improvement in BCVA postoperatively at 3 months. Petalloid multilayered inverted internal limiting membrane flap under PFCL technique with adjunctive use of i-OCT showed improved morphological and functional outcomes in the treatment of extra-large MHs. We present here a large series of extra-large MHs, in which a novel technique of petalloid multilayered inverted ILM flaps was used.

• Publisher: Medknow Publications and Media Pvt. Ltd
• Subject: Perfluorocarbons