Ophthalmology. Retina · 2026
Highly Myopic Macular Hole Surgery by the Internal Limiting Membrane Flap with No Gas Tamponade Technique: A Prospective Interventional Case Series.
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Szeto Simon K H, Yu Amy H Y, Hui Vivian W K, Lam Julia T W, Tsang Ken K, Lin Timothy P H, Pang Christopher M K, Tang Ziqi, Lai Timothy Y Y, Mohamed Shaheeda, Tsang Chi Wai
Аннотация
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 of ≤-6.0 diopters (in phakic eyes) or axial length (AL) ≥26 mm. The ILM flap without gas tamponade technique was used for MH repair; conversion to conventional surgery with gas tamponade was the contingency surgical plan when necessary.
MAIN OUTCOMES MEASURES: Primary outcome was the MH closure rate at week 12. Key secondary outcomes included postoperative 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 the median duration of symptoms was 9.5 months. The mean ± standard deviation baseline logarithm of the minimum angle of resolution BCVA was 0.77 ± 0.39, the mean AL was 28.9 ± 2.20 mm, and the mean minimum linear diameter was 424.0 ± 197.7 μm. All participants underwent the planned study intervention and completed the week 12 visit for the assessment of the primary outcome. Macular hole 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 postoperative mean logarithm of the minimum angle of resolution 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 postoperative day 1 and weeks 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 weeks 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 postoperative visual recovery. Results from this study support the need for a collaborative multicenter randomized controlled trial.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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 of ≤-6.0 diopters (in phakic eyes) or axial length (AL) ≥26 mm. The ILM flap without gas tamponade technique was used for MH repair; conversion to conventional surgery with gas tamponade was the contingency surgical plan when necessary.
MAIN OUTCOMES MEASURES: Primary outcome was the MH closure rate at week 12. Key secondary outcomes included postoperative 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 the median duration of symptoms was 9.5 months. The mean ± standard deviation baseline logarithm of the minimum angle of resolution BCVA was 0.77 ± 0.39, the mean AL was 28.9 ± 2.20 mm, and the mean minimum linear diameter was 424.0 ± 197.7 μm. All participants underwent the planned study intervention and completed the week 12 visit for the assessment of the primary outcome. Macular hole 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 postoperative mean logarithm of the minimum angle of resolution 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 postoperative day 1 and weeks 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 weeks 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 postoperative visual recovery. Results from this study support the need for a collaborative multicenter randomized controlled trial.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.