HIỆU QUẢ ĐIỀU TRỊ LÂU DÀI BONG VÕNG MẠC DO LỖ HOÀNG ĐIỂM TRÊN CẬN THỊ NẶNG BẰNG KỸ THUẬT PHỦ VẠT MÀNG GIỚI HẠN TRONG

Abstract

Introduction: Macular hole retinal detachment (MHRD) in patients with high myopia presents a significant challenge for vitreoretinal surgeons due to its complex pathogenesis. This study aims to evaluate the long-term efficacy of the inverted internal limiting membrane (ILM) flap technique in treating this condition. Methods: A prospective study was conducted on 63 eyes diagnosed with MHRD, all treated with vitrectomy and the ILM flap technique, from February 2022 to September 2024. The follow-up period was at least 24 months post-surgery. Surgical success was defined by retinal reattachment, macular hole closure, and improved visual acuity. Retinal microstructural recovery was assessed using optical coherence tomography (OCT). Surgical complications and factors influencing surgical outcomes were analyzed. Results: Retinal reattachment was achieved in 92.1% of eyes, and macular hole closure in 93.6%. Significant visual acuity improvement was observed in 87.3% of cases, with an average gain of 0.9 logMAR. Recovery rates of the external limiting membrane,, ellipsoid zone, and cone outer segment tips were 76.2%, 61.9%, and 61.9%, respectively. The most common complications were cataract formation and increased intraocular pressure. Factors influencing surgical outcomes included the extent of retinal detachment and macular hole size. Conclusions: The ILM flap technique represents a significant breakthrough in the treatment of MHRD, enhancing anatomical recovery and improving visual function, thereby enhancing patients' quality of life.