Internal Limiting Membrane Surgery

Preface
Contents
Part I: Principles and Techniques of Internal Limiting Membrane Surgery
	1: Terminology
		1.1	 Introduction
		1.2	 Terminology of ILM Surgery
			1.2.1	 ILM Peeling
			1.2.2	 ILM Insertion
			1.2.3	 ILM Flap
		References
	2: Anatomy of Internal Limiting Membrane
		2.1	 Introduction
		2.2	 Histology
		2.3	 Biochemical Composition
		2.4	 Topographical Variation
		2.5	 Aging Changes of the ILM
		2.6	 Changes of the ILM in Diabetes
		2.7	 Role of the ILM in Proliferative Diseases
		References
	3: Instrument
		3.1	 Introduction
		3.2	 Microforceps
			3.2.1	 ILM Forceps (Fig. 3.1a)
			3.2.2	 Asymmetrical Forceps (Fig. 3.1b)
			3.2.3	 End-Grasping Forceps (Fig. 3.1c)
			3.2.4	 Maxgrip Forceps (Fig. 3.1d)
			3.2.5	 Serrated Forceps (Fig. 3.1e)
		3.3	 Scraper
		3.4	 Micropick
		3.5	 Cannulas
		3.6	 Lens
	4: Vital Dye
		4.1	 Introduction
		4.2	 Vital Dyes
			4.2.1	 Indocyanine Green
			4.2.2	 Brilliant Blue G
			4.2.3	 Trypan Blue
			4.2.4	 Infracyanine Green
			4.2.5	 Triamcinolone Acetonide
		4.3	 Double Staining
		References
	5: Vitreous Substitute
		5.1	 Introduction
		5.2	 Vitreous Substitute
			5.2.1	 Intraocular Gas
			5.2.2	 Silicone Oil
			5.2.3	 Perfluorocarbon Liquid
		5.3	 Expansile vs. Non-expansile
			5.3.1	 Expansile Intraocular Tamponade
			5.3.2	 Non-expansile Intraocular Tamponade
		5.4	 Interfacial Tension and Surface Tension
		5.5	 Buoyancy and Specific Gravity
		5.6	 Volume of Intraocular Tamponade
			5.6.1	 Injection Volume
			5.6.2	 Duration of Tamponade Effect
		5.7	 Refractive Index
		5.8	 Summary
		References
	6: Internal Limiting Membrane Peeling
		6.1	 Introduction
		6.2	 Rationale of ILM Peeling Surgery
		6.3	 Surgical Technique
			6.3.1	 Induction of Posterior Vitreous Detachment
			6.3.2	 Initiation of ILM Peeling
			6.3.3	 Peeling the ILM
		6.4	 Complications of ILM Peeling
		References
	7: Internal Limiting Membrane Insertion
		7.1	 Introduction
		7.2	 Rationale of ILM Insertion Surgery
		7.3	 Surgical Techniques of ILM Insertion
			7.3.1	 ILM Insertion with Peeling
			7.3.2	 Free ILM Insertion
			7.3.3	 ILM Insertion Without Peeling
		7.4	 Pitfalls of ILM Insertion
			7.4.1	 Determining an Amount of ILM Sheet to Be Inserted
			7.4.2	 Retinal Pigment Epithelial Atrophy
			7.4.3	 Fluid-Air Exchange
		References
	8: Internal Limiting Membrane Flap
		8.1	 Introduction
		8.2	 Rationale of ILM Flap Surgery
		8.3	 Making ILM Flap
			8.3.1	 ILM Flap Without Peeling
			8.3.2	 ILM Flap with Peeling
			8.3.3	 Free ILM Flap
		8.4	 Maintaining ILM Flap Position
			8.4.1	 Fluid-Air Exchange
			8.4.2	 Flap Site
			8.4.3	 Stabilizer
		8.5	 Alternative Options for ILM Flap
			8.5.1	 Multiple Free ILM Insertion
			8.5.2	 Lens Capsule
			8.5.3	 Autologous Retinal Patch Graft
		References
	9: Macular Changes after Internal Limiting Membrane Surgery
		9.1	 Introduction
		9.2	 Dissociated Optic Nerve Fiber Layer
		9.3	 Macular Deformation after ILM Peeling
			9.3.1	 Foveal Asymmetric Elongation
			9.3.2	 Foveal Displacement
			9.3.3	 Macular Deformation
			9.3.4	 Macular Deformation and Metamorphopsia
		9.4	 Summary
		References
Part II: Internal Limiting Membrane Surgery in Retinal Diseases
	10: Idiopathic Macular Hole
		10.1	 Introduction
		10.2	 Start-up Checks for MH Surgery
		10.3	 ILM Surgery Techniques for MH
			10.3.1	 ILM Peeling
			10.3.2	 ILM Insertion or Flap Without Peeling (Fig. 10.2)
			10.3.3	 ILM Insertion with Peeling (Fig. 10.3)
			10.3.4	 ILM Flap with Peeling (Fig. 10.4)
			10.3.5	 Free ILM Insertion
			10.3.6	 Free ILM Flap
			10.3.7	 Lens Capsular Insertion
			10.3.8	 Autologous Retinal Graft
		10.4	 Surgical Results of MH Surgery
			10.4.1	 Anatomical Outcomes
			10.4.2	 Functional Outcomes
		References
	11: Epiretinal Membrane
		11.1	 Introduction
		11.2	 Rationale of ILM Peeling in ERM Surgery
		11.3	 Surgical Techniques
			11.3.1	 Step-by-Step Technique
			11.3.2	 En bloc Technique
			11.3.3	 Considerations for ILM Peeling in ERM Surgery
		11.4	 Surgical Outcomes of ERM Surgery with ILM Peeling
		References
	12: Diabetic Macular Edema
		12.1	 Introduction
		12.2	 Mechanism and Indication of Vitrectomy for DME
		12.3	 Surgical Technique
		12.4	 Surgical Outcomes and Management of Persisting DME After Vitrectomy
		References
	13: Myopic Tractional Maculopathy
		13.1	 Introduction
		13.2	 Pathogenesis and Diagnosis
			13.2.1	 Inward Traction by Abnormalities of VMI
			13.2.2	 Outward Traction Due to Posterior Staphyloma
			13.2.3	 Diagnosis of MTM
		13.3	 When to Operate
		13.4	 Surgical Techniques
			13.4.1	 Vitrectomy with ILM Peeling
			13.4.2	 Vitrectomy Without ILM Peeling
			13.4.3	 Vitrectomy with Fovea-Sparing ILM Peeling
			13.4.4	 Tamponade
		13.5	 Surgical Outcomes
		References
	14: Macular Hole Retinal Detachment
		14.1	 Introduction
		14.2	 Pathogenesis
		14.3	 Surgical Technique
			14.3.1	 Resolving Inward Traction
			14.3.2	 Removing Subretinal Fluid
			14.3.3	 Closing Macular Hole
		14.4	 Outcomes
		References
	15: Rhegmatogenous Retinal Detachment
		15.1	 Introduction
		15.2	 Rationale of ILM Peeling in RRD Surgery
		15.3	 Debates of ILM Peeling During Vitrectomy for RRD
			15.3.1	 Pros
			15.3.2	 Cons
			15.3.3	 Debate Regarding Concurrent ILM Peeling
		15.4	 Selective ILM Peeling in RRD Surgery
		15.5	 Surgical Procedures
			15.5.1	 Considerations Before Peeling
			15.5.2	 Vital Dye
			15.5.3	 Surgical Technique
		References
	16: Optic Disc Pit Maculopathy
		16.1	 Introduction
		16.2	 Pathophysiology
		16.3	 Surgical Techniques
			16.3.1	 ILM Peeling
			16.3.2	 ILM Flap
			16.3.3	 Laser Photocoagulation
		16.4	 Surgical Outcomes
		References