ILM Flap Repositioning for Persistent Macular Hole

We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the...
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Autor*in:	Gregor Kastl [verfasserIn] Peter Heidenkummer [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	inverted flap persistent macular hole reoperation repositioning vitrectomy

Übergeordnetes Werk:	In: Case Reports in Ophthalmology - Karger Publishers, 2010, 13(2022), 2, Seite 499-503
Übergeordnetes Werk:	volume:13 ; year:2022 ; number:2 ; pages:499-503

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1159/000525303

Katalog-ID:	DOAJ041024389

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520			\|a We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered.
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allfields	10.1159/000525303 doi (DE-627)DOAJ041024389 (DE-599)DOAJa8046aee6292463c9e679f9bb537f053 DE-627 ger DE-627 rakwb eng RE1-994 Gregor Kastl verfasserin aut ILM Flap Repositioning for Persistent Macular Hole 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered. inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology Peter Heidenkummer verfasserin aut In Case Reports in Ophthalmology Karger Publishers, 2010 13(2022), 2, Seite 499-503 (DE-627)637421213 (DE-600)2577666-6 16632699 nnns volume:13 year:2022 number:2 pages:499-503 https://doi.org/10.1159/000525303 kostenfrei https://doaj.org/article/a8046aee6292463c9e679f9bb537f053 kostenfrei https://www.karger.com/Article/FullText/525303 kostenfrei https://doaj.org/toc/1663-2699 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2022 2 499-503
spelling	10.1159/000525303 doi (DE-627)DOAJ041024389 (DE-599)DOAJa8046aee6292463c9e679f9bb537f053 DE-627 ger DE-627 rakwb eng RE1-994 Gregor Kastl verfasserin aut ILM Flap Repositioning for Persistent Macular Hole 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered. inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology Peter Heidenkummer verfasserin aut In Case Reports in Ophthalmology Karger Publishers, 2010 13(2022), 2, Seite 499-503 (DE-627)637421213 (DE-600)2577666-6 16632699 nnns volume:13 year:2022 number:2 pages:499-503 https://doi.org/10.1159/000525303 kostenfrei https://doaj.org/article/a8046aee6292463c9e679f9bb537f053 kostenfrei https://www.karger.com/Article/FullText/525303 kostenfrei https://doaj.org/toc/1663-2699 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2022 2 499-503
allfields_unstemmed	10.1159/000525303 doi (DE-627)DOAJ041024389 (DE-599)DOAJa8046aee6292463c9e679f9bb537f053 DE-627 ger DE-627 rakwb eng RE1-994 Gregor Kastl verfasserin aut ILM Flap Repositioning for Persistent Macular Hole 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered. inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology Peter Heidenkummer verfasserin aut In Case Reports in Ophthalmology Karger Publishers, 2010 13(2022), 2, Seite 499-503 (DE-627)637421213 (DE-600)2577666-6 16632699 nnns volume:13 year:2022 number:2 pages:499-503 https://doi.org/10.1159/000525303 kostenfrei https://doaj.org/article/a8046aee6292463c9e679f9bb537f053 kostenfrei https://www.karger.com/Article/FullText/525303 kostenfrei https://doaj.org/toc/1663-2699 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2022 2 499-503
allfieldsGer	10.1159/000525303 doi (DE-627)DOAJ041024389 (DE-599)DOAJa8046aee6292463c9e679f9bb537f053 DE-627 ger DE-627 rakwb eng RE1-994 Gregor Kastl verfasserin aut ILM Flap Repositioning for Persistent Macular Hole 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered. inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology Peter Heidenkummer verfasserin aut In Case Reports in Ophthalmology Karger Publishers, 2010 13(2022), 2, Seite 499-503 (DE-627)637421213 (DE-600)2577666-6 16632699 nnns volume:13 year:2022 number:2 pages:499-503 https://doi.org/10.1159/000525303 kostenfrei https://doaj.org/article/a8046aee6292463c9e679f9bb537f053 kostenfrei https://www.karger.com/Article/FullText/525303 kostenfrei https://doaj.org/toc/1663-2699 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2022 2 499-503
allfieldsSound	10.1159/000525303 doi (DE-627)DOAJ041024389 (DE-599)DOAJa8046aee6292463c9e679f9bb537f053 DE-627 ger DE-627 rakwb eng RE1-994 Gregor Kastl verfasserin aut ILM Flap Repositioning for Persistent Macular Hole 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered. inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology Peter Heidenkummer verfasserin aut In Case Reports in Ophthalmology Karger Publishers, 2010 13(2022), 2, Seite 499-503 (DE-627)637421213 (DE-600)2577666-6 16632699 nnns volume:13 year:2022 number:2 pages:499-503 https://doi.org/10.1159/000525303 kostenfrei https://doaj.org/article/a8046aee6292463c9e679f9bb537f053 kostenfrei https://www.karger.com/Article/FullText/525303 kostenfrei https://doaj.org/toc/1663-2699 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2022 2 499-503
language	English
source	In Case Reports in Ophthalmology 13(2022), 2, Seite 499-503 volume:13 year:2022 number:2 pages:499-503
sourceStr	In Case Reports in Ophthalmology 13(2022), 2, Seite 499-503 volume:13 year:2022 number:2 pages:499-503
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	inverted flap persistent macular hole reoperation repositioning vitrectomy Ophthalmology
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container_title	Case Reports in Ophthalmology
authorswithroles_txt_mv	Gregor Kastl @@aut@@ Peter Heidenkummer @@aut@@
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callnumber-first	R - Medicine
author	Gregor Kastl
spellingShingle	Gregor Kastl misc RE1-994 misc inverted flap misc persistent macular hole misc reoperation misc repositioning misc vitrectomy misc Ophthalmology ILM Flap Repositioning for Persistent Macular Hole
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topic_title	RE1-994 ILM Flap Repositioning for Persistent Macular Hole inverted flap persistent macular hole reoperation repositioning vitrectomy
topic	misc RE1-994 misc inverted flap misc persistent macular hole misc reoperation misc repositioning misc vitrectomy misc Ophthalmology
topic_unstemmed	misc RE1-994 misc inverted flap misc persistent macular hole misc reoperation misc repositioning misc vitrectomy misc Ophthalmology
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title	ILM Flap Repositioning for Persistent Macular Hole
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title_full	ILM Flap Repositioning for Persistent Macular Hole
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title_sort	ilm flap repositioning for persistent macular hole
callnumber	RE1-994
title_auth	ILM Flap Repositioning for Persistent Macular Hole
abstract	We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered.
abstractGer	We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered.
abstract_unstemmed	We present a case of a persistent macular hole which was initially treated by pars plana vitrectomy with the inverted ILM flap technique. In a second procedure, the internal limiting membrane (ILM) flap was mobilized from its perifoveal adherence to the retina and peeled back to its adherence at the foveal ring. The eye was filled with 25% C2F6 gas. Three weeks after the second procedure, closure of the hole was observed. Best corrected visual acuity increased from 20/400 to 20/50. We assume that contractile elements within the ILM may cause perifoveal adhesion and centrifugal effects preventing macular hole closure. If macular hole closure does not occur after surgery with an inverted ILM flap, it is worth to peel back the existing flap again towards the foveal edge in order to induce hole closure and preserve the benefits of flap surgery. If the flap is only attached to the foveal ring, centripetal contraction could lead to annular closure of the macular hole. If the flap is lost, alternative surgical methods for refractory MHs should be considered.
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title_short	ILM Flap Repositioning for Persistent Macular Hole
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tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4367</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">13</subfield><subfield code="j">2022</subfield><subfield code="e">2</subfield><subfield code="h">499-503</subfield></datafield></record></collection>
score	7.398258

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ILM Flap Repositioning for Persistent Macular Hole

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