Outcomes of inverted internal limiting membrane flap surgery for chronic large macular holes in a sub-Saharan African setting

Abstract

Topic

Outcomes of inverted internal limiting membrane (ILM) flap surgery for chronic large macular holes (MH) in a sub-Saharan Africa setting.

Purpose

To report the anatomic and visual outcomes of ILM flap surgery without face-down positioning for eyes with chronic large MH at Eye Foundation Hospital, Lagos, Nigeria.

Design

Retrospective, observational study.

Methods

Case files of patients who underwent inverted ILM flap surgery for large MH in the retina unit of the Eye Foundation Hospital, Lagos, Nigeria, between January 2022 and December 2022 were reviewed.

Results

The study included 30 eyes of 29 patients. MH size was between 471 μm and 1530 μm. The mean overall preoperative best corrected logMAR visual acuity was 1.27 ± 0.58. A one-line worsening of preoperative logMAR vision was associated with an increase in MH size by 129.5 μm (p = 0.056). MH closure was achieved in 90% of eyes. There was an improvement in mean best corrected postoperative logMAR visual acuity at 6 months to 0.83 ± 0.49 (p < 0.001). Good visual outcomes were seen in 60.7% of eyes. The remodeling of the external limiting membrane seen in 46.7% of eyes was associated with good visual outcomes (p = 0.04).

Conclusion

There was a 90% anatomic closure rate for chronic large MHs that underwent inverted internal limiting membrane flap surgery among our series of patients in a sub-Saharan African setting. Good visual outcomes were seen in 60.7% of eyes, with an overall improvement in logMAR visual acuity.