Optical Coherence Tomography Morphological Features Following Modified Internal Limiting Membrane Surgical Technique In Traumatic Macular Holes

Hammouda Hamdy Ghoraba,¹ Mahmoud Leila,² Hashem Ghoraba,³ Mohamed Amin Heikal,⁴ Hosam Othman Mansour<sup>5

1</sup>Faculty of Medicine, Tanta University, Tanta, Egypt and Medical Director, Magrabi Eye Hospital, Tanta, Egypt; ²Retina Department, Research Institute of Ophthalmology, Giza, Egypt; ³Magrabi Eye Hospital, Tanta, Egypt; ⁴Faculty of Medicine, Benha University, Benha, Egypt; ⁵Faculty of Medicine, Al Azhar University, New Damietta City, Egypt

Correspondence: Mahmoud Leila
Retina Department, Research Institute of Ophthalmology, 2, Al-Ahram Street, Giza, Egypt
Tel +201286644025
Email mahmoudleila@yahoo.com

Objective: To describe the optical coherence tomography (OCT) findings in terms of macular hole closure and ellipsoid zone (EZ) recovery following modified internal limiting membrane (ILM) surgical technique in traumatic macular holes (TMH).
Methods: The study was a retrospective case series that recruited 16 consecutive patients with TMH. Following vitrectomy (PPV), we performed modified ILM surgical technique (IFT) in which ILM peel was stopped at the edges of the hole forming a floating ILM flap. Primary outcome measures were pattern of TMH closure and recovery of EZ. Student’s T-test and Pearson’s correlation coefficient were used for statistical analysis.
Results: The study had 16 eyes of 16 patients. Mean baseline minimum linear diameter (MLD) was 562μ. Mean baseline best-corrected visual acuity (BCVA) was 1.4 logMAR. U-pattern closure occurred in 50% of eyes, V-pattern closure occurred in 31.2% of eyes, whereas W-pattern closure occurred in 18.7% of eyes. Mean BCVA improvement was 5 lines (p 0.02). Failure of recovery of EZ was detected in 75% of eyes. In the present series, neither pre-operative MLD nor time lapse prior to surgery were significant factors in determining the closure pattern of TMH, the grade of EZ recovery or final BCVA.
Conclusion: Modified IFT is effective in promoting macular hole closure and improving visual acuity in patients with TMH. The technique does not promote recovery of EZ.

Keywords: modified ILM surgical technique, traumatic FTMH, ILM peel adjuvants, ILM blue-assisted ILM peel, ellipsoid zone recovery