A delphi consensus study for treatment of full-thickness macular hole in Taiwan
Abstract To establish a consensus for surgical management of full-thickness macular hole (FTMH) and macular hole retinal detachment (MHRD). Nine experienced vitreoretinal surgeons from Taiwan participated in questionnaire for surgical management of FTMH and MHRD based on Delphi methodology. Among th...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-06929-3 |
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| author | Meng-Ju Tsai Chung-May Yang Chang-Hao Yang San-Ni Chen Shwu-Jiuan Sheu Shih-Jen Chen Tzyy-Chang Ho Tsung-Tien Wu Chi-Chun Lai Cheng-Kuo Cheng |
| author_facet | Meng-Ju Tsai Chung-May Yang Chang-Hao Yang San-Ni Chen Shwu-Jiuan Sheu Shih-Jen Chen Tzyy-Chang Ho Tsung-Tien Wu Chi-Chun Lai Cheng-Kuo Cheng |
| author_sort | Meng-Ju Tsai |
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| description | Abstract To establish a consensus for surgical management of full-thickness macular hole (FTMH) and macular hole retinal detachment (MHRD). Nine experienced vitreoretinal surgeons from Taiwan participated in questionnaire for surgical management of FTMH and MHRD based on Delphi methodology. Among the 49 items, 30 items (61.2%) reached strong consensus after 2 rounds. For FTMH, strong consensus included routine internal limiting membrane (ILM) peeling in all stages of FTMH, ILM flap in large holes ≥ 400 μm, ILM flap covering technique, small peeling area < 5 mm diameter, preservation of adherent epiretinal membrane in the flap if it cannot be separated from ILM, C3F8 as preferred tamponade for ILM peeling alone but not in the presence of ILM flap, post-operative facedown position, simple intravitreal gas injection for early persistent holes, use of pedicle flap or SWIFT for persistent holes in previously small area-peeled macula. For MHRD, strong consensus included the use of ILM flap, ILM flap covering technique, preservation of adherent epiretinal membrane if it cannot be separated from ILM, C3F8 as preferred tamponade, post-operative facedown position, no intentional subretinal fluid drainage during air-fluid exchange in small RD area within arcade, intraoperative use of adjuvants. Strong consensus achieved in a significant portion of key questions frequently encountered in the management of FTMH and MHRD. Recommendations from this Delphi study helps in decision-making for clinical practice. |
| format | Article |
| id | doaj-art-94ff3dff468c40b097b2bb31e4bacc2e |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-94ff3dff468c40b097b2bb31e4bacc2e2025-08-20T03:03:27ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-06929-3A delphi consensus study for treatment of full-thickness macular hole in TaiwanMeng-Ju Tsai0Chung-May Yang1Chang-Hao Yang2San-Ni Chen3Shwu-Jiuan Sheu4Shih-Jen Chen5Tzyy-Chang Ho6Tsung-Tien Wu7Chi-Chun Lai8Cheng-Kuo Cheng9Department of Ophthalmology, Evergreen General HospitalSchool of Medicine, National Taiwan UniversitySchool of Medicine, National Taiwan UniversityDepartment of Ophthalmology, China Medical University HospitalDepartment of Ophthalmology, Kaohsiung Medical University HospitalDepartment of Ophthalmology, Taipei Veterans General HospitalSchool of Medicine, National Taiwan UniversitySchool of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Ophthalmology, Linkou Medical Center, Chang Gung Memorial HospitalDepartment of Ophthalmology, Shin Kong Wu Ho-Su Memorial HospitalAbstract To establish a consensus for surgical management of full-thickness macular hole (FTMH) and macular hole retinal detachment (MHRD). Nine experienced vitreoretinal surgeons from Taiwan participated in questionnaire for surgical management of FTMH and MHRD based on Delphi methodology. Among the 49 items, 30 items (61.2%) reached strong consensus after 2 rounds. For FTMH, strong consensus included routine internal limiting membrane (ILM) peeling in all stages of FTMH, ILM flap in large holes ≥ 400 μm, ILM flap covering technique, small peeling area < 5 mm diameter, preservation of adherent epiretinal membrane in the flap if it cannot be separated from ILM, C3F8 as preferred tamponade for ILM peeling alone but not in the presence of ILM flap, post-operative facedown position, simple intravitreal gas injection for early persistent holes, use of pedicle flap or SWIFT for persistent holes in previously small area-peeled macula. For MHRD, strong consensus included the use of ILM flap, ILM flap covering technique, preservation of adherent epiretinal membrane if it cannot be separated from ILM, C3F8 as preferred tamponade, post-operative facedown position, no intentional subretinal fluid drainage during air-fluid exchange in small RD area within arcade, intraoperative use of adjuvants. Strong consensus achieved in a significant portion of key questions frequently encountered in the management of FTMH and MHRD. Recommendations from this Delphi study helps in decision-making for clinical practice.https://doi.org/10.1038/s41598-025-06929-3Delphi consensusFull-thickness macular holeMacular hole retinal detachmentSurgical management |
| spellingShingle | Meng-Ju Tsai Chung-May Yang Chang-Hao Yang San-Ni Chen Shwu-Jiuan Sheu Shih-Jen Chen Tzyy-Chang Ho Tsung-Tien Wu Chi-Chun Lai Cheng-Kuo Cheng A delphi consensus study for treatment of full-thickness macular hole in Taiwan Scientific Reports Delphi consensus Full-thickness macular hole Macular hole retinal detachment Surgical management |
| title | A delphi consensus study for treatment of full-thickness macular hole in Taiwan |
| title_full | A delphi consensus study for treatment of full-thickness macular hole in Taiwan |
| title_fullStr | A delphi consensus study for treatment of full-thickness macular hole in Taiwan |
| title_full_unstemmed | A delphi consensus study for treatment of full-thickness macular hole in Taiwan |
| title_short | A delphi consensus study for treatment of full-thickness macular hole in Taiwan |
| title_sort | delphi consensus study for treatment of full thickness macular hole in taiwan |
| topic | Delphi consensus Full-thickness macular hole Macular hole retinal detachment Surgical management |
| url | https://doi.org/10.1038/s41598-025-06929-3 |
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