Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia

PurposeTo compare the efficacy of macular buckling (MB) alone against a combined internal limiting membrane (ILM) inversion flap for full-thickness macular hole (FTMH)-associated macular detachment (MD) in patients with high myopia.MethodsThis was a prospective interventional case series of patients with high myopia surgically treated with MB alone or combined with an inverted ILM flap for FTMH- associated MD. Best-corrected visual acuity (BCVA) at the 24-month postoperative follow-up, rate of initial retinal reattachment and macular hole closure were measured.ResultsA total of 62 eyes from 62 participants (33 in the MB group, 29 in the combination group) were studied. Postoperative BCVA improved significantly in both the combination group (P < 0.001) and the MB group (P = 0.027). The postoperative BCVA at 12 months (P = 0.021) and 24 months (P = 0.041) was significantly better in the combination group than in the MB group. The postoperative BCVA was not significantly different between the eyes with closed and unclosed MH at each follow-up time point (P > 0.05). In the combination group, we observed earlier retinal reattachment and closure of the MH as well as a higher rate of MH closure (82.8% vs. 66.7%) than in the MB group, although this difference was insignificant (P = 0.248).ConclusionMB combined with the ILM flap inversion technique achieved better postoperative BCVA and a higher success rate of MH closure than MB alone. We believe that combination surgery should be preferentially recommended.

Automated summary

This study aimed to compare the efficacy of macular buckling (MB) alone versus combined internal limiting membrane (ILM) inversion flap for the treatment of full-thickness macular hole (FTMH)-associated macular detachment (MD) in patients with high myopia. The results showed that patients treated with MB combined with the ILM flap inversion technique had better postoperative visual acuity and a higher rate of macular hole closure. Therefore, combination surgery is recommended.