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INVERTED INTERNAL LIMITING MEMBRANE FLAP PLUS FOVEA-SPARING PEELING AND REPOSITIONING: A NOVEL APPROACH FOR MYOPIC TRACTION MACULOPATHY.

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Τίτλος: INVERTED INTERNAL LIMITING MEMBRANE FLAP PLUS FOVEA-SPARING PEELING AND REPOSITIONING: A NOVEL APPROACH FOR MYOPIC TRACTION MACULOPATHY.
Συγγραφείς: Lu PT; Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan., Yeung L; Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan., Kang EY; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York; and., Chou HD; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan., Chen KJ; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Hwang YS; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Wu WC; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Lai CC; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Ophthalmology, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan.
Πηγή: Retinal cases & brief reports [Retin Cases Brief Rep] 2026 Sep 01; Vol. 20 (5), pp. 695-700.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101298744 Publication Model: Print Cited Medium: Internet ISSN: 1937-1578 (Electronic) Linking ISSN: 19351089 NLM ISO Abbreviation: Retin Cases Brief Rep Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, MD : Wolters Kluwer Health, c2007-
Ιατρικοί όροι (MeSH): Vitrectomy*/methods , Retinal Perforations*/surgery , Retinal Perforations*/etiology , Fovea Centralis*/surgery , Myopia, Degenerative*/complications , Myopia, Degenerative*/surgery , Basement Membrane*/surgery , Retinoschisis*/surgery , Surgical Flaps*, Fluorocarbons/administration & dosage ; Humans ; Retrospective Studies ; Visual Acuity ; Female ; Male ; Middle Aged ; Tomography, Optical Coherence ; Aged ; Endotamponade
Περίληψη: Purpose: To examine the efficacy and safety of IPS procedure-comprising an i nverted internal limiting membrane (ILM) flap, fovea-sparing peeling, and repositioning assisted by the subperfluoro-n-octane injection of an ophthalmic viscoelastic device-in eyes with myopic traction maculopathy (MTM) and a high risk of postoperative full-thickness macular hole (FTMH) formation.
Methods: This retrospective, consecutive, and interventional case series included eight MTM cases with lamellar macular hole and foveal detachment (FD). All patients underwent vitrectomy with IPS procedure and gas tamponade, with a minimum follow-up of 6 months.
Results: Between April and November 2024, eight consecutive eyes underwent IPS, with a median follow-up of 414 days. The cohort included two men (25%) and six women (75%), with a mean age of 62 years and a mean axial length of 29.83 mm. Mean VA improved from 0.54 to 0.23 logMAR (Snellen equivalent, 20/70 to 20/35), and mean central foveal thickness decreased from 571.6 μm to 279.5 μm. No eyes developed postoperative FTMH. Retinoschisis was completely resolved in five eyes (62.5%), and FD was reversed in five out of six eyes (83.3%). Inner retinal dimples were noted in four eyes (50.0%) and were confined to areas exposed by the inverted ILM flap, with no inner retinal dimples in the ILM-repositioning area.
Conclusion: IPS relieves traction, restores ILM integrity, minimizes inner retinal surgical trauma, and protects an ultrathin fovea, thereby reducing the risk of postvitrectomy FTMH and achieving functional and morphologic improvements in patients with MTM at high risk for postoperative FTMH.
References: Panozzo G, Mercanti A. Optical coherence tomography findings in myopic traction maculopathy. Arch Ophthalmol 2004;122:1455–1460.
Baba T, Ohno-Matsui K, Futagami S, et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia. Am J Ophthalmol 2003;135:338–342.
Kobayashi H, Kishi S. Vitreous surgery for highly myopic eyes with foveal detachment and retinoschisis. Ophthalmology 2003;110:1702–1707.
Shimada N, Sugamoto Y, Ogawa M, et al. Fovea-sparing internal limiting membrane peeling for myopic traction maculopathy. Am J Ophthalmol 2012;154:693–701.
Ho TC, Chen MS, Huang JS, et al. Foveola nonpeeling technique in internal limiting membrane peeling of myopic foveoschisis surgery. Retina 2012;32:631–634.
Feng J, Shao Q, Xie J, et al. Comparison of three internal limiting membrane peeling techniques for myopic ttraction maculopathy with high risk of postoperative macular hole development. Retina 2023;43:1872–1880.
Zheng D, Huang Z, Zeng Q, et al. Anatomical and visual outcomes of fovea-sparing internal limiting membrane peeling with or without inverted flap technique for myopic foveoschisis. BMC Ophthalmol 2022;22:444.
Wakabayashi T, Shiraki N, Tsuboi K, et al. Risk factors and outcomes of postoperative macular hole formation after vitrectomy for myopic traction maculopathy: SCHISIS report no. 2. Ophthalmol Retina 2023;7:779–787.
Lin J-P, Yang C-M. Combined fovea-sparing internal limiting membrane peeling with internal limiting membrane flap technique for progressive myopic traction maculopathy. Graefes Archive Clin Exp Ophthalmol 2022;260:489–496.
Chou H-D, Teh WM, Wu W-C, et al. Peeling and internal limiting membrane reposition (PAIR) for myopic foveoschisis. Retina 2023;43:2134–2138.
Gohil R, Sivaprasad S, Han LT, et al. Myopic foveoschisis: a clinical review. Eye (Lond) 2015;29:593–601.
Al-Badawi AH, Abdelhakim M, Macky TA, Mortada HA. Efficacy of non-fovea-sparing ILM peeling for symptomatic myopic foveoschisis with and without macular hole. Br J Ophthalmol 2019;103:257–263.
Gao X, Ikuno Y, Fujimoto S, Nishida K. Risk factors for development of full-thickness macular holes after pars plana vitrectomy for myopic foveoschisis. Am J Ophthalmol 2013;155:1021–1027.e1.
Shiraki N, Wakabayashi T, Ikuno Y, et al. Fovea-sparing versus standard internal limiting membrane peeling for myopic traction maculopathy: a study of 102 consecutive cases. Ophthalmol Retina 2020;4:1170–1180.
Jin H, Zhang Q, Zhao P. Fovea sparing internal limiting membrane peeling using multiple parafoveal curvilinear peels for myopic foveoschisis: technique and outcome. BMC Ophthalmol 2016;16:180.
Sekine R, Kogo J, Jujo T, et al. Efficacy of fovea-sparing internal limiting membrane peeling for epiretinal membrane foveoschisis. Ophthalmic Res 2022;65:162–170.
Polito A, Garruto G, Maggio E, et al. Fovea-sparing internal limiting membrane peeling with inverted flap technique versus standard internal limiting membrane peeling for symptomatic myopic foveoschisis. Sci Rep 2024;14:2460.
Wakatsuki Y, Nakashizuka H, Tanaka K, et al. Outcomes of vitrectomy with fovea-sparing and inverted ILM flap technique for myopic foveoschisis. J Clin Med 2022;11:1274.
Ramirez-Estudillo A, Rojas-Juarez S, Ramirez-Galicia X, et al. A novel technique using lyophilized amniotic membrane patch (LAMPatch) as primary procedure in patients with myopic traction maculopathy with macular detachment. Clin Ophthalmol 2024;18:2473–2480.
Ito Y, Terasaki H, Takahashi A, et al. Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes. Ophthalmology 2005;112:1415–1420.
Nukada K, Hangai M, Ooto S, et al. Tomographic features of macula after successful macular hole surgery. Invest Ophthalmol Vis Sci 2013;54:2417–2428.
Ho TC, Yang CM, Huang JS, et al. Foveola nonpeeling internal limiting membrane surgery to prevent inner retinal damages in early stage 2 idiopathic macula hole. Graefes Arch Clin Exp Ophthalmol 2014;252:1553–1560.
Spaide RF. “Dissociated optic nerve fiber layer appearance” after internal limiting membrane removal is inner retinal dimpling. Retina 2012;32:1719–1726.
Chou H-D, Chong Y-J, Teh WM, et al. Nasal or temporal internal limiting membrane flap assisted by sub-perfluorocarbon viscoelastic injection for macular hole repair. Am J Ophthalmol 2021;223:296–305.
Lai CC, Wu AL, Chou HD, et al. Sub-perfluoro-n-octane injection of ocular viscoelastic device assisted inverted internal limiting membrane flap for macular hole retinal detachment surgery: a novel technique. BMC Ophthalmol 2020;20:116.
Contributed Indexing: Keywords: internal limiting membrane peeling; myopic foveoschisis; myopic traction maculopathy; pathologic myopia; surgical technique; vitrectomy
Substance Nomenclature: 0 (Fluorocarbons)
Entry Date(s): Date Created: 20260218 Date Completed: 20260826 Latest Revision: 20260826
Update Code: 20260827
DOI: 10.1097/ICB.0000000000001889
PMID: 41707074
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1937-1578
DOI:10.1097/ICB.0000000000001889