Innovative Non-Inverted ILM Free Flap Covering Technique for Unclosed Macular Hole Repair.

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-09-04 DOI:10.1016/j.ajo.2025.09.002

Xuerui Zhang,Yu Xu,Wenting Zhang,Yuan Yang,Jiawei Yin,Huanyu Liu,Victoria Y Gu,Haodong Xiao,Shipeng Guo,Jie Peng,Peiquan Zhao

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引用次数: 0

Abstract

OBJECTIVE To examine the safety and effectiveness of non-inverted ILM Free Flap combined with the SPOT technique (Sub-Perfluorocarbon liquid (PFCL) injection of Ocular viscoelastic device (OVD) Technique) in the treatment of unclosed macular holes (MHs). DESIGN Retrospective interventional case series. PARTICIPANTS Eight patients (8 eyes) with persistent unclosed MHs were treated at a tertiary eye hospital in China from September 2023 to February 2025. All procedures were performed by the same vitreoretinal surgeon(P.Q.Z.). METHODS Enhanced ILM peeling and a limited ILM flap harvested outside the peeling margin to cover the MH. A combination of PFCL and OVD (SPOT technique) was applied to stabilize the ILM flap. MAIN OUTCOMES AND MEASURES Primary outcome was anatomical closure of the MH within one month postoperatively. Secondary outcomes included best-corrected visual acuity (BCVA) and structural restoration of the external limiting membrane (ELM), outer nuclear layer (ONL), and ellipsoid zone (EZ) on optical coherence tomography (OCT). RESULTS All MHs achieved anatomical closure within one month. U-shaped closure was noted in six eyes (75%) and V-shaped in two eyes (25%). BCVA improved in all eyes at final follow-up. OCT showed reconstitution of the ELM, ONL, and EZ bands in all cases. CONCLUSIONS These findings demonstrate that the innovative combination of the non-inverted, single-layered ILM-free flap with the SPOT technique is effective in treating unclosed MH and improving VA. This approach offers a new solution for unclosed MH and its effectiveness needs to be validated by more well-designed research.

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创新的非倒置ILM游离皮瓣覆盖技术用于非闭合性黄斑裂孔修复。

目的探讨非内翻性ILM游离皮瓣联合SPOT技术（亚氟化碳液体注射眼粘弹性装置技术）治疗未闭黄斑孔的安全性和有效性。设计回顾性介入病例系列。研究人员于2023年9月至2025年2月在中国一家三级眼科医院治疗了8例（8只眼）持续性未闭合性MHs。所有手术均由同一位玻璃体视网膜外科医生（p.q.z）完成。方法强化ILM剥离，在剥离边缘外取有限ILM皮瓣覆盖MH，采用PFCL联合OVD （SPOT技术）稳定ILM皮瓣。主要结果和测量方法主要结果为术后1个月内MH解剖闭合。次要结果包括光学相干断层扫描（OCT）的最佳矫正视力（BCVA）和外限制膜（ELM）、外核层（ONL）和椭球区（EZ）的结构恢复。结果所有mhh均在1个月内实现解剖闭合。u形闭合6眼（75%），v形闭合2眼（25%）。最终随访时，所有眼BCVA均有改善。OCT显示所有病例的ELM、ONL和EZ波段均有重建。结论非倒置、单层无ilm皮瓣与SPOT技术的创新结合，可有效治疗不闭合性MH，改善VA，为不闭合性MH提供了新的解决方案，其有效性有待进一步的研究验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.