Postoperative Dynamics of Full-Thickness Macular Holes: Insights from High-Resolution OCT Under Gas Tamponade
Abstract
Purpose: To characterize early healing processes of full-thickness macular holes (MHs) after pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flap using high-resolution swept-source OCT (SS-OCT) under gas tamponade.
Design: Prospective, single-center, interventional, multisurgeon consecutive case series.
Subjects: Consecutive eyes with idiopathic full-thickness MHs undergoing PPV with the inverted ILM flap technique.
Methods: All eyes underwent standardized 25-gauge PPV with temporal inverted ILM flap and 14% octafluoropropane (C3F8) gas tamponade. Pre- and postoperative assessment included high-resolution SS-OCT at predefined intervals from immediately after surgery through 3 months, enabling sequential in vivo evaluation of early and late morphologic changes under gas tamponade.
Main outcome measures: Evaluated features included MH diameter, ILM flap position, hyperreflective bridging tissue, and integrity of the external limiting membrane (ELM) and ellipsoid zone. Closure rates and best-corrected visual acuity (BCVA) were analyzed relative to early SS-OCT findings.
Results: Swept-source OCT imaging succeeded in all 32 eyes despite the gas-filled vitreous cavity. Macular hole closure was documented in 22 eyes (67%) by day 1, 29 eyes (88%) by week 1, and 30 eyes (94%) by month 1. Early intraretinal hyperreflectivity was observed in 30 eyes (94%), correlating with successful closure; its absence was noted in the delayed cases. External limiting…
How strong is the evidence?
Evidence Hub reads this as a case series. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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