Comparison of the inverted internal limiting membrane flap technique without versus with an autologous blood clot for treating macular hole-associated retinal detachment.

IF 4.1 1区医学 Q1 OPHTHALMOLOGY Eye and Vision Pub Date : 2025-01-02 DOI:10.1186/s40662-024-00417-x

Ke Zhu, Yingchao Wang, Boya Lei, Ling Chen, Yanqiong Zhang, Qing Chang, Gezhi Xu, Yingqin Ni

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Abstract

Background: To investigate the anatomical and functional outcomes of macular hole-associated retinal detachment (MHRD) after vitrectomy using the inverted internal limiting membrane (ILM) flap technique with autologous blood clot (ABC).

Methods: This retrospective observational study included 80 eyes with MHRD that underwent vitrectomy with ILM flap without (46 eyes) or with ABC (34 eyes). Fundus photography and optical coherence tomography were evaluated. The pre- and postoperative best-corrected visual acuities (BCVAs) and BCVA improvement were compared between the two groups.

Results: The MH closure rates after initial surgery were similar in the ILM flap group and ILM flap with ABC group [40 (87%) vs. 29 (85%) eyes, respectively]. The proportion of eyes with hyperreflective bridging tissue (HBT) was lower in the ILM flap group than ILM flap with ABC group [13 (32%) vs. 16 (55%) eyes, P = 0.060]. The postoperative improvement in BCVA was significantly better in the ILM flap group (P = 0.027). Multiple linear regression analysis revealed that preoperative BCVA was positively associated with postoperative improvement in BCVA (β = 0.638, P = 0.000), while the ILM flap with ABC technique was negatively associated with postoperative improvement in BCVA (β = - 0.299, P = 0.039, adjusted r² = 0.415).

Conclusions: The inverted ILM flap technique alone resulted in better foveal configurations and visual outcomes than the ILM flap technique combined with ABC in patients with MHRD.

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不加自体血凝块的倒置内限制膜瓣技术治疗黄斑孔相关性视网膜脱离的比较。

背景：应用自体血凝块（ABC）倒置内限制膜（ILM）瓣技术观察玻璃体切除术后黄斑孔相关性视网膜脱离（MHRD）的解剖和功能结局。方法：本回顾性观察研究包括80只MHRD眼，分别行玻璃体切除术（无ILM皮瓣）和玻璃体切除术（ABC）。眼底摄影和光学相干断层扫描进行评价。比较两组患者术前、术后最佳矫正视力（BCVAs）及BCVA改善情况。结果：ILM瓣组和ILM瓣联合ABC组术后MH闭合率相近[40眼（87%）比29眼（85%）]。ILM瓣组高反射桥组织（HBT）眼的比例低于ILM瓣+ ABC组[13（32%）对16（55%）眼，P = 0.060]。ILM皮瓣组BCVA术后改善明显优于ILM皮瓣组（P = 0.027）。多元线性回归分析显示术前BCVA与术后BCVA改善呈正相关（β = 0.638, P = 0.000），而采用ABC技术的ILM皮瓣与术后BCVA改善呈负相关（β = - 0.299, P = 0.039，调整后r2 = 0.415）。结论：在MHRD患者中，单纯逆行上膜瓣技术比上膜瓣联合ABC技术具有更好的中央凹结构和视觉效果。

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

Eye and Vision OPHTHALMOLOGY-

CiteScore

8.60

自引率

2.40%

发文量

审稿时长

15 weeks

期刊介绍： Eye and Vision is an open access, peer-reviewed journal for ophthalmologists and visual science specialists. It welcomes research articles, reviews, methodologies, commentaries, case reports, perspectives and short reports encompassing all aspects of eye and vision. Topics of interest include but are not limited to: current developments of theoretical, experimental and clinical investigations in ophthalmology, optometry and vision science which focus on novel and high-impact findings on central issues pertaining to biology, pathophysiology and etiology of eye diseases as well as advances in diagnostic techniques, surgical treatment, instrument updates, the latest drug findings, results of clinical trials and research findings. It aims to provide ophthalmologists and visual science specialists with the latest developments in theoretical, experimental and clinical investigations in eye and vision.