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KMID : 0360220230640100971
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Journal of the Korean Ophthalmological Society
2023 Volume.64 No. 10 p.971 ~ p.975
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ILM Insertion for the Treatment of Macular Hole Associated with Phakic Intraocular Lens Implantation
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Heo Jun
Park Bo-Hyun
Kwon Han-Jo
Park Sung-Who
Byon Ik-Soo
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Abstract
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Purpose: To report a case of macular hole closure using an internal limiting membrane (ILM) flap following implantation of a posterior chamber phakic implantable contact lens (ICL).
Case summary: An 18-year-old female patient presented with visual loss of the left eye after ICL implantation. She had high myopia of -12.5 diopter (spherical equivalent) and a corrected visual acuity of 2/100. The fundus photograph and optical coherence tomography showed a full-thickness macular hole measuring 688 μm in width and 976 μm in length. The ILM around the hole was detached from the retinal surface, which was greater in size than the macular hole. The initial surgical intervention involved vitrectomy, inverted ILM flap placement, and gas tamponade. The decrease in gas volume was associated with a loss of the ILM flap. For hole closure, the remaining ILM flap in the peripheral macula was harvested and inserted in the hole during the second surgery. The silicone oil was used for tamponade. One month after ILM insertion, complete closure of the hole was observed.
The visual acuity improved to 20/40 after silicone oil removal.
Conclusions: A large full-thickness macular hole developed after ICL implantation in a patient with high myopia. Macular hole surgery using ILM insertion and prolonged tamponade closed the hole and effectively improved the visual acuity.
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KEYWORD
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Internal limiting membrane insertion, Macular hole, Phakic intraocular lens
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