16.06.2018 | Editorial
ILM peeling in macular hole retinal detachment: insert or not?
verfasst von:
Chi-Chun Lai
Erschienen in:
Graefe's Archive for Clinical and Experimental Ophthalmology
|
Ausgabe 8/2018
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Excerpt
Vitrectomy with internal limiting membrane (ILM) peeling has gained in popularity; it has become the most effective surgical approach for macular hole retinal detachment (MHRD), which is thought to result from tangential traction and anteroposterior traction of the macula. An alternative proposal was to use inverted ILM flap techniques to improve the success rates based on the mechanism that ILM may function as a scaffold for the proliferation and migration of Muller cells [
1]. The concept was confirmed firstly by Michalewska et al. in larger macular hole (MH) to facilitate the healing process and now has been extended for use in treating MHRD [
2]. However, vitreoretinal surgeons are still asking, “Is the inverted ILM flap technique still a preferable option for MHRD?” Previous direct comparison studies have suggested contradictory results [
3‐
6]. On this issue, Wakabayashi et al. reported that the inverted ILM insertion technique seems to improve the anatomical results in terms of MH closure rate rather than the functional results of MHRD despite there being a tendency for better postoperative visual acuity in the inverted ILM insertion group. …