Authors: Liu Guangfeng, Ma Zhizhong, Ma Lie, Jiang Yanrong
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Objective
To evaluate the therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole (IMH).
Methods
The clinical data of 25 eyes with IMH of 408-939 μm in 23 patients who received pars plana vitrectomy with internal limiting membrane (ILM) peeling and flute-needle vacuum assistant hole closure technique from Feburary in 2017 to June in 2018 in Peking University International Hospital were retrospectively analyzed.The changes of best corrected visual acuity (BCVA) before and after operation were evaluated.The shapes of the hole closure were categorized, and the manifestations of outer retina were observed by optical coherence tomography (OCT), including external limiting membrane (ELM) and ellipsoid zone(EZ).
Results
The hole closure rate after surgery were 100%(25/25), with the U type closure in 16 eyes and V type closure in 9 eyes.The BCVA was 0.76±0.27 after operation, which was significantly improved in comparison with 1.05±0.29 before operation (t=3.61, P=0.01). The ELM of OCT image was (1 050.00±380.39)μm before operation, and that after operation reduced to (623.32±328.66)μm, showing a significant difference between them (t=6.63, P=0.00). A fully reduced EZ band was seen after operation in comparison with before operation ([1 147.28±354.41]μm versus ([818.28±247.33]μm)(t=4.12, P=0.00).
Conclusions
A combination procedure of vitrectomy with flute-needle vacuum assistant hole closure technique is effective for large IMH, which is beneficial to the anatomical repair and functional recovery of outer retina.