Simon K H Szeto, Amy H Y Yu, Vivian W K Hui, Julia T W Lam, Ken K Tsang, Timothy P H Lin, Christopher M K Pang, Ziqi Tang, Timothy Y Y Lai, Shaheeda Mohamed, Chi Wai Tsang
{"title":"Highly Myopic Macular Hole Surgery by the Internal Limiting Membrane Flap with No Gas Tamponade Technique: A Prospective Interventional Case Series.","authors":"Simon K H Szeto, Amy H Y Yu, Vivian W K Hui, Julia T W Lam, Ken K Tsang, Timothy P H Lin, Christopher M K Pang, Ziqi Tang, Timothy Y Y Lai, Shaheeda Mohamed, Chi Wai Tsang","doi":"10.1016/j.oret.2026.04.023","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To report the surgical outcomes of the internal limiting membrane (ILM) flap with no gas tamponade technique in managing high myopia associated macular hole (MH).</p><p><strong>Design: </strong>Prospective interventional case series.</p><p><strong>Participants: </strong>Patients with high myopia associated full thickness MH.</p><p><strong>Methods: </strong>Consecutive patients with high myopia associated MH were prospectively recruited. High myopia was defined as refraction of spherical equivalence (SE) of ≤ -6.0D (in phakic eyes) or axial length (AL) ≥26mm. The ILM flap without gas tamponade technique was used for MH repair, conversion to conventional surgery with gas tamponade is a contingency surgical plan when necessary.</p><p><strong>Main outcomes measures: </strong>Primary outcome was the MH closure rate at week 12. Key secondary outcomes included post-operative best corrected visual acuity (BCVA) and time to MH closure.</p><p><strong>Results: </strong>Twenty eyes from 20 patients were included. The mean age was 67.2 years, and median duration of symptoms was 9.5 months. The mean ± standard deviation (SD) baseline logarithm of the minimum angle of resolution (logMAR) BCVA was 0.77 ± 0.39, mean axial length (AL) was 28.9mm ± 2.20 and the mean minimum linear diameter (MLD) was 424.0μm ± 197.7. All participants underwent the planned study intervention and completed week 12 visit for the assessment of primary outcome. MH closure was achieved in 20 (100%) eyes at week 12 and the median time to MH closure was 1 week (range, 0-12 weeks). The post-operative mean logMAR BCVA was 0.75 ± 0.29 (p=0.832), 0.50 ± 0.25 (p=0.013), 0.36 ± 0.21 (p<0.001), 0.30 ± 0.21 (p<0.001) and 0.25 ± 0.23 (p<0.001) at post-operative day 1, week 1, 4, 12 and 24, respectively. The number of eyes with BCVA ≥ 20/50 increased from 6 (30%) on day 1 to 12 (60%), 17 (85%), 18 (90%) and 18 (94.7%) at week 1, 4, 12 and 24, respectively.</p><p><strong>Conclusions: </strong>The ILM flap with no gas tamponade technique is effective in repairing high myopia associated MH, achieving a high closure rate and quick post-operative visual recovery. Results from this study support the need for a collaborative multi-center randomized controlled trial.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Retina","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.oret.2026.04.023","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To report the surgical outcomes of the internal limiting membrane (ILM) flap with no gas tamponade technique in managing high myopia associated macular hole (MH).
Design: Prospective interventional case series.
Participants: Patients with high myopia associated full thickness MH.
Methods: Consecutive patients with high myopia associated MH were prospectively recruited. High myopia was defined as refraction of spherical equivalence (SE) of ≤ -6.0D (in phakic eyes) or axial length (AL) ≥26mm. The ILM flap without gas tamponade technique was used for MH repair, conversion to conventional surgery with gas tamponade is a contingency surgical plan when necessary.
Main outcomes measures: Primary outcome was the MH closure rate at week 12. Key secondary outcomes included post-operative best corrected visual acuity (BCVA) and time to MH closure.
Results: Twenty eyes from 20 patients were included. The mean age was 67.2 years, and median duration of symptoms was 9.5 months. The mean ± standard deviation (SD) baseline logarithm of the minimum angle of resolution (logMAR) BCVA was 0.77 ± 0.39, mean axial length (AL) was 28.9mm ± 2.20 and the mean minimum linear diameter (MLD) was 424.0μm ± 197.7. All participants underwent the planned study intervention and completed week 12 visit for the assessment of primary outcome. MH closure was achieved in 20 (100%) eyes at week 12 and the median time to MH closure was 1 week (range, 0-12 weeks). The post-operative mean logMAR BCVA was 0.75 ± 0.29 (p=0.832), 0.50 ± 0.25 (p=0.013), 0.36 ± 0.21 (p<0.001), 0.30 ± 0.21 (p<0.001) and 0.25 ± 0.23 (p<0.001) at post-operative day 1, week 1, 4, 12 and 24, respectively. The number of eyes with BCVA ≥ 20/50 increased from 6 (30%) on day 1 to 12 (60%), 17 (85%), 18 (90%) and 18 (94.7%) at week 1, 4, 12 and 24, respectively.
Conclusions: The ILM flap with no gas tamponade technique is effective in repairing high myopia associated MH, achieving a high closure rate and quick post-operative visual recovery. Results from this study support the need for a collaborative multi-center randomized controlled trial.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
