ILM Inverted Flap Size in Macular Hole

NCT ID: NCT04683276

Last Updated: 2020-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-01

Study Completion Date

2020-10-01

Brief Summary

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In the current study, the investigators described the results of a randomized, comparative clinical trial that was conducted to study the impact of the size of internal limiting membrane (ILM) inverted flap on rate and timing of idiopathic macular hole closure.

Detailed Description

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A prospective randomized comparative study included patients with idiopathic macular hole (MH) attending outpatient clinic.Eligible eyes were divided into 2 groups based on the narrowest diameter of the MH measured by spectral domain optical coherence tomography (SD-OCT). MHs from 250 to 400µm were classified as Medium-sized MHs and MHs \> 400 µm were classified as Large-sized MHs. Within each group, eyes were randomly assigned to either small-flap (1-2DD) or large flap (from \>2 to 4DD).

Conditions

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Idiopathic Macular Hole

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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small flap medium-sized macular hole (SFMM)

small flap (1-2 disc-diameter) was performed in medium sized macular hole (250-400 um)

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy with ILM inverted flap

Intervention Type PROCEDURE

Complete vitrectomy was done with the aid of triamcinolone acetonide followed by fluid-air exchange. Staining of the ILM was carried with 0.05% solution of Brilliant Blue dye (BBG), (Ocublue plus, Aurolab, India) for 30 seconds, ILM peeling was proceeded leaving a circle of ILM measuring approximately 1-2 DD in SF groups and \>2 to 4DD in LF group, centered around the MH. The ILM outside the parafoveal area was peeled to the arcade. The ILM around the hole was then detached from the retina up to the edge of the hole. The ILM flap around the edge of the hole was inverted over the MH using a scraper.

large flap medium-sized macular hole (LFMM)

large flap (3-4 disc-diameter) was performed in medium sized macular hole (250-400 um)

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy with ILM inverted flap

Intervention Type PROCEDURE

Complete vitrectomy was done with the aid of triamcinolone acetonide followed by fluid-air exchange. Staining of the ILM was carried with 0.05% solution of Brilliant Blue dye (BBG), (Ocublue plus, Aurolab, India) for 30 seconds, ILM peeling was proceeded leaving a circle of ILM measuring approximately 1-2 DD in SF groups and \>2 to 4DD in LF group, centered around the MH. The ILM outside the parafoveal area was peeled to the arcade. The ILM around the hole was then detached from the retina up to the edge of the hole. The ILM flap around the edge of the hole was inverted over the MH using a scraper.

small flap large-sized macular hole (SFLM)

small flap (1-2 disc-diameter) was performed in Large sized macular hole (\>400 um)

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy with ILM inverted flap

Intervention Type PROCEDURE

Complete vitrectomy was done with the aid of triamcinolone acetonide followed by fluid-air exchange. Staining of the ILM was carried with 0.05% solution of Brilliant Blue dye (BBG), (Ocublue plus, Aurolab, India) for 30 seconds, ILM peeling was proceeded leaving a circle of ILM measuring approximately 1-2 DD in SF groups and \>2 to 4DD in LF group, centered around the MH. The ILM outside the parafoveal area was peeled to the arcade. The ILM around the hole was then detached from the retina up to the edge of the hole. The ILM flap around the edge of the hole was inverted over the MH using a scraper.

large flap Large-sized macular hole (LFLM)

large flap (3-4 disc-diameter) was performed in large sized macular hole (\>400 um)

Group Type ACTIVE_COMPARATOR

pars plana vitrectomy with ILM inverted flap

Intervention Type PROCEDURE

Complete vitrectomy was done with the aid of triamcinolone acetonide followed by fluid-air exchange. Staining of the ILM was carried with 0.05% solution of Brilliant Blue dye (BBG), (Ocublue plus, Aurolab, India) for 30 seconds, ILM peeling was proceeded leaving a circle of ILM measuring approximately 1-2 DD in SF groups and \>2 to 4DD in LF group, centered around the MH. The ILM outside the parafoveal area was peeled to the arcade. The ILM around the hole was then detached from the retina up to the edge of the hole. The ILM flap around the edge of the hole was inverted over the MH using a scraper.

Interventions

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pars plana vitrectomy with ILM inverted flap

Complete vitrectomy was done with the aid of triamcinolone acetonide followed by fluid-air exchange. Staining of the ILM was carried with 0.05% solution of Brilliant Blue dye (BBG), (Ocublue plus, Aurolab, India) for 30 seconds, ILM peeling was proceeded leaving a circle of ILM measuring approximately 1-2 DD in SF groups and \>2 to 4DD in LF group, centered around the MH. The ILM outside the parafoveal area was peeled to the arcade. The ILM around the hole was then detached from the retina up to the edge of the hole. The ILM flap around the edge of the hole was inverted over the MH using a scraper.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Eyes with stage 4 idiopathic MHs with a diameter \>250µm on spectral domain optical coherence tomography (SD-OCT)

Exclusion Criteria

* traumatic MH
* myopic MHs,
* MH secondary to retinal detachment,
* long-standing MH\> 12 months
* previous retinal surgeries
* high myopia with an axial length \> 26.0 mm
* other ocular pathologies interfering with the interpretation of the OCT reports.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mansoura University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Ophthalmic center

Al Mansurah, Dakahelia, Egypt

Site Status

Countries

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Egypt

Other Identifiers

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ILM flap size

Identifier Type: -

Identifier Source: org_study_id