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Objective <p>To evaluate the anatomical and functional outcomes of our novel surgery (a three-step approach) and the conventional inverted internal limiting membrane flap technique (IFT) in treating large full-thickness macular holes (FTMHs).</p> Methods <p>This was a retrospective, consecutive, nonrandomized comparative study of patients who underwent either the novel surgery (<i>n</i> = 27, Group A) or IFT (<i>n</i> = 27, Group B). The main outcomes of MH closure rates and the best corrected visual acuity (BCVA) at 1-, 3-, and 6-month follow-up were compared between the two groups.</p> Results <p>At 6 months postoperatively, MH closure was achieved in 24/27 patients in Group A and 22/27 patients in Group B (88.89% vs. 81.48%, <i>P</i> = 0.704) with U-shaped closure rates being significantly higher in Group A (<i>P = 0.029</i>). The average BCVA at month 6 was 0.69 ± 0.38 (LogMAR) in Group A and 0.91 ± 0.39 in Group B (<i>P = 0.015</i>) with the improvement in BCVA being significantly higher in Group A (0.50 ± 0.59 vs. 0.31 ± 0.59, <i>P</i> = 0.045). The recovery rates of ELM were significantly higher in Group A (<i>P = 0.026</i>).</p> Conclusions <p>Our three-step approach greatly improves anatomical and functional outcomes compared with IFT. This novel surgery has a dominant advantage in earlier and higher ultimate closure rate, U-type closure rate, and ELM recovery rate, and more importantly, better recovery of BCVA.</p>

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A three-step approach versus the inverted internal limiting membrane flap technique in large full thickness macular hole surgery: a comparative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月8日

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  • Dongwei Lai,
  • Siao Tang,
  • Chufeng Gu,
  • Chunren Meng,
  • Chunyang Cai,
  • Shuai He,
  • Qinghua Qiu

摘要

Objective

To evaluate the anatomical and functional outcomes of our novel surgery (a three-step approach) and the conventional inverted internal limiting membrane flap technique (IFT) in treating large full-thickness macular holes (FTMHs).

Methods

This was a retrospective, consecutive, nonrandomized comparative study of patients who underwent either the novel surgery (n = 27, Group A) or IFT (n = 27, Group B). The main outcomes of MH closure rates and the best corrected visual acuity (BCVA) at 1-, 3-, and 6-month follow-up were compared between the two groups.

Results

At 6 months postoperatively, MH closure was achieved in 24/27 patients in Group A and 22/27 patients in Group B (88.89% vs. 81.48%, P = 0.704) with U-shaped closure rates being significantly higher in Group A (P = 0.029). The average BCVA at month 6 was 0.69 ± 0.38 (LogMAR) in Group A and 0.91 ± 0.39 in Group B (P = 0.015) with the improvement in BCVA being significantly higher in Group A (0.50 ± 0.59 vs. 0.31 ± 0.59, P = 0.045). The recovery rates of ELM were significantly higher in Group A (P = 0.026).

Conclusions

Our three-step approach greatly improves anatomical and functional outcomes compared with IFT. This novel surgery has a dominant advantage in earlier and higher ultimate closure rate, U-type closure rate, and ELM recovery rate, and more importantly, better recovery of BCVA.