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Temporal inverted ILM flap technique improves macular hole repair in wet or dry AMD eyes

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Zofia Michalewska

CHICAGO — Patients coexisting with dry or wet age-related macular degeneration and macular holes experienced improved vision, anatomic and functional results after undergoing a temporal inverted internal limiting membrane technique to treat their full-thickness macular holes, according to a speaker here.

“The inverted ILM flap technique might be successful in full-thickness macular holes coexisting with dry AMD. Visual acuity improves and closure is achieved after the first intervention in nearly 90% of eyes,” Zofia Michalewska, MD, PhD, said at the American Society of Retina Specialists annual meeting.

The retrospective, observational case study included 20 eyes of 18 patients with full-thickness macular holes and dry or wet age-related macular degeneration (AMD). The mean minimum macular hole diameter was 493 m and the mean maximum macular hole diameter was 1,072 m in the cohort.

Patients underwent an inverted internal limiting membrane flap technique and 88% achieved full-thickness macular hole closure after the first surgery. All patients achieved full closure after the second surgery, she said.

“Final visual acuity was 0.47 Snellen, which is slightly worse than idiopathic cases,” Michalewska said.

Unlike idiopathic eyes, there was no correlation between macular hole diameter and final visual acuity. The only prognosticator was visual acuity before surgery, she said.

Drusen decreased or disappeared in four patients and geographic atrophy development was possible. One eye developed geographic atrophy 12 years after successful macular hole surgery, she said. – by Robert Linnehan

Reference: Michalewska Z. Vitrectomy With the Inverted ILM Flap Technique in Eyes With Full Thickness Macular Hole Coexisting With Age-Related Macular Degeneration. Presented at: American Society of Retina Specialists annual meeting; July 27-30, 2019; Chicago.

Disclosure: Michalewska reports no relevant financial disclosures.