Ganglion cell layer changes following the idiopathic macular hole surgery using inverted limiting membrane flap technique

The purpose of this study is to compare the ganglion cell layer changes following temporal inverted internal limiting membrane flap (i-ILMF) surgery for idiopathic macular hole (IMH). This retrospective study included 50 eyes that underwent vitrectomy with a 2.5-disc-diameter temporal inverted internal limiting membrane flap (i-ILMF) technique. Demographic, functional, and anatomical data were collected before and after the surgery. The best corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings such as ganglion cell layer -inner plexiform layer (GCL-IPL) thickness and hole related parameters/indexes were compared in the preoperative period and 6th month after surgery. The average age of the patients was 68.8 ± 10.31 years, and the average duration of visual loss was 10.95 ± 6.54 months. The average GCL-IPL thickness increased significantly from 57.98 ± 21.43 μm to 68.74 ± 13.62 μm at 6 months after surgery (p < 0.001). The nasal GCL-IPL thickness was significantly increased from 56.94 ± 24.18 μm to 73.10 ± 15.39 μm after 6 months after surgery (p < 0.001). The temporal i-ILMF technique not only leads to high anatomical success and visual improvement but also results in a significant increase in GCL-IPL thickness postoperatively, suggesting a unique structural response to this method.