ArticleBMC ophthalmology2020
Inverted internal limiting membrane flap technique versus complete internal limiting membrane peeling in large macular hole surgery: a comparative study.
Article in BMC ophthalmology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Clinical characteristics, imaging features, and treatment outcomes of macular telangiectasia type 2: a comprehensive meta-analysis.Scientific reports · 2026Pooled it
- Critical analysis of macular hole repair techniques: a comprehensive systematic review and meta-analysis comparing internal limiting membrane flap and internal limiting membrane peeling for any size of macular hole.BMC ophthalmology · 2025Pooled it
- EFFICACY AND SAFETY OF AMNIOTIC MEMBRANE TRANSPLANTATION IN VITRECTOMY FOR EXTRA-LARGE OR LONG-STANDING MACULAR HOLES: A Prospective Clinical Study.Retina (Philadelphia, Pa.) · 2026Observational
- Macular micro vascular changes following macular hole repair: optical coherence tomography angiography study.International journal of retina and vitreous · 2026Article
- Surgical Outcomes of Vitrectomy with Flower-Petal Fovea-Sparing Inverted Internal Limiting Membrane Flap Technique for Myopic Tractional Maculopathy with Retinal Detachment: A Retrospective Study.Journal of clinical medicine · 2025Article
- Ganglion cell layer changes following the idiopathic macular hole surgery using inverted limiting membrane flap technique.BMC ophthalmology · 2025Article
- Comparison of ILM peeling vs. inverted ILM flap for macular hole closure and visual outcomes: systematic review and meta-analysis.International journal of retina and vitreous · 2025Review
- A delphi consensus study for treatment of full-thickness macular hole in Taiwan.Scientific reports · 2025Article
- Amniotic Membrane Coverage for Intractable Large Macular Holes: A First Report with Japanese Patients.Journal of clinical medicine · 2025Article
- Machine Learning and Optical-Coherence-Tomography-Derived Radiomics Analysis to Predict the Postoperative Anatomical Outcome of Full-Thickness Macular Hole.Bioengineering (Basel, Switzerland) · 2024Article
- [Predictive parameters for anatomical surgical success in full-thickness macular holes : A retrospective evaluation of 391 eyes].Die Ophthalmologie · 2024Article
- Modified ILM flap techniques versus classical inverted ILM flap technique for large macular holes: a systematic review and meta-analysis of randomized controlled trials.International journal of retina and vitreous · 2024Article
- Accuracy of generative deep learning model for macular anatomy prediction from optical coherence tomography images in macular hole surgery.Scientific reports · 2024Article
- Temporal inverted internal limiting membrane flap technique for myopic macular hole retinal detachment reconstruction.The Journal of international medical research · 2024Article
- Anatomical and functional results after vitrectomy with conventional ILM peeling versus inverted ILM flap technique in large full-thickness macular holes.International journal of retina and vitreous · 2023Article
- Comparison of long-term visual and anatomical outcomes between internal limiting membrane flap and peeling techniques for macular holes with a propensity score analysis.Eye (London, England) · 2023Article
- Comparative study of conventional internal limiting membrane peeling versus temporal inverted internal limiting membrane flap for large macular hole treatment.Indian journal of ophthalmology · 2023Article
- Visual improvement and regeneration of retinal layers in eyes with small, medium, and large idiopathic full-thickness macular holes treated with the inverted internal limiting membrane flap technique over a period of 12 months.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022Article
- Spotlight on the Internal Limiting Membrane Technique for Macular Holes: Current Perspectives.Clinical ophthalmology (Auckland, N.Z.) · 2022Review
- Update on surgical management of complex macular holes: a review.International journal of retina and vitreous · 2021Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo compare the anatomical and functional outcomes of the inverted internal limiting membrane (ILM) flap technique and the complete ILM removal in the treatment of large stage 4 macular hole (MH) > 400 μm and to evaluate reconstructive anatomical changes in foveal microstructure using spectral-domain optical coherence tomography.
methodsThis is a retrospective, consecutive, nonrandomized comparative study of patients affected by idiopathic, myopic or traumatic stage 4 MH (minimum diameter > 400 μm) treated with 25-gauge pars-plana vitrectomy with either complete ILM peeling (n = 23, Group 1) or inverted ILM flap technique (n = 23, Group 2), between August 2016 and August 2018. Main outcomes measured were the MH closure rate assessed by spectral-domain optical coherence tomography and the best-corrected visual acuity (BCVA) at six months. Foveal microstructure reconstructive changes were evaluated using SD-OCT to determine predictive factors of postoperative BCVA.
resultsClosure of MH was achieved in 16/23 cases of Group 1 (70%) and in 22/23 cases of the Group 2 (96%). Surgical failure was reported in 6 cases of Group 1 and 1 case of Group 2. The MH closure rate was significantly higher with the inverted ILM flap technique (P-value = 0.02). Average BCVA (LogMAR) changed from 1.04 ± 0.32 to 0.70 ± 0.31 in Group 1 and from 0.98 ± 0.22 to 0.45 ± 0.25 in Group 2 (P-value = 0.005) at 6 months. Improvement in BCVA (> 0.3 LogMAR units) was statistically higher in the Group 2 (P-value = 0.03). Restoration of foveal microstructure was significantly higher in the Group 2 at 6 months (52% vs 9%, P-value < 0.01). In Group 2, the integrity of the external limiting membrane at 3 months postoperatively was the only significant feature correlated with postoperative BCVA at 6 months (r = 0.562; P-Value = 0.01, forward stepwise regression analysis).
conclusionInverted ILM flap technique is more effective than the classic ILM peeling for the closure of large stage 4 MHs > 400 μm, improving both anatomical and functional outcomes. Early recovery of the external limiting membrane at 3 months is a positive predictive value of postoperative BCVA 6 months after inverted ILM flap technique.
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