Comparison of anatomical and functional results in cases who had classical surgery or inverted flap due to idiopathic macular hole

Eighty-six eyes of 86 patients who applied to Mersin University Medical Faculty Hospital Ophthalmology Department between January 01, 2014 and September 30, 2021 and underwent classical surgery or inverted temporal flap with the diagnosis of macular hole (MD) were included in the study. Patients who underwent classical surgery were included in group-1 (n=58), and patients who underwent inverted temporal flap were included in group-2 (n=28). MD surgery success rates, complications and optical coherence tomography (OCT) findings in each group were evaluated separately and compared with each other. Of the patients included in the study, 30 (34.9%) were male and 56 were female. While the mean age of the patients in group-1 was 69.31±7.21 years, the mean age of the patients in group-2 was 66,027±5.86 years. The MD dimensions and MD stages of the patients in the groups are summarized in Table 5, and MD base diameter (p=0.71), MD height (p=0.59), MD minimum diameter (p=0.92), MD dimensions before and after surgery are given between the two groups. There was no statistical difference in terms of temporal retinal thickness (p=0.44, p=0.096, respectively) and stage distribution (p=0.46). When the vertical hyperreflective line appearance in OCT was evaluated, it was found that the hyperreflective line appearance in group 1 was significantly higher than in group 2 (p<0.0001). The visual acuity (VA) of the patients in Group-1 was 0.12±0.10 before surgery and 0.27±0.24 at the 6th month after surgery, and the difference was significant (p<0.0001). Similarly, while the preoperative VA of the patients in group-2 was 0.09±0.07, it was 0.31±0.18 at the 6th month after surgery, and the difference was significant (p<0.0001). There was no significant difference between the two groups in terms of preoperative and postoperative VA (p=0.14; p=0.42, respectively). When the MD closure rates in both groups were examined, there was no significant difference between the two groups, both independently of the phase and according to the phases. Similarly, the rate of reoperation was close to each other in both groups and no significant difference was observed (p=0.68). In the present study, it was observed that there was a significant increase in postoperative visual acuity with both techniques applied for MD surgery and that the two techniques were not superior to each other in this respect. Similarly, similar anatomical success rates were obtained with both 7 techniques. When the OCT parameters are evaluated, it is seen that a better healing pattern is obtained with the flap technique. Keywords: Macular hole, internal limiting membrane peeling, temporal flap, OCT.