ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Tamponade-free superior ILM flap for idiopathic macular hole repair: a pilot study.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo report the feasibility, anatomical closure, and visual outcomes after a tamponade-free, perfluorocarbon liquid (PFCL)-free, viscoelastic-assisted superior internal limiting membrane (ILM) flap technique for idiopathic full-thickness macular holes (FTMH).
methodsProspective, non-comparative pilot study of consecutive adults with idiopathic FTMH undergoing 25-gauge pars plana vitrectomy, superior ILM flap creation and intraoperative stabilization with dispersive viscoelastic. No PFCL, gas, or air tamponade was used, and no face-down positioning was required. Minimum follow-up was 3 months.
resultsTwenty-six patients, fifteen women (57.7%) and eleven men (42.3%) were included in the study. The mean age was 72.2 ± 8.5 years (range 51-88). Mean minimum linear diameter (MLD) was 341.2 ± 191.8 μm (range 50-775 μm); 9 holes were small (< 250 μm), 10 were medium (250-400 μm), and 7 were large (> 400 μm). The mean duration of symptoms was 4.85 ± 3.34 months. Primary anatomical closure after one procedure occurred in 25/26 cases (96.2% primary success). The mean follow-up was 4.77 ± 1.37 months. Best-corrected visual acuity improved significantly (from 1.12 logMAR, to 0.46 logMAR, p < 0.001). Two intraoperative retinal tears occurred during posterior vitreous detachment (PVD) induction and were treated with endolaser; no postoperative retinal detachment, hypotony, or endophthalmitis occurred.
conclusionIn this prospective pilot series, a PFCL-free, tamponade/air-free, viscoelastic-assisted superior ILM flap technique was associated with a high primary closure rate without postoperative positioning. Larger comparative studies with longer follow-up are needed to assess generalizability and complication rates, particularly for large macular holes.
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