The Cloverleaf Internal Limiting Membrane Flap Technique for Repair of Challenging Macular Holes
Why this work is in the frame
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Bibliographic record
Abstract
PURPOSE: This study introduces the cloverleaf internal limiting membrane (ILM) flap technique for managing challenging macular holes, aiming to enhance ILM flap placement and improve functional and anatomical outcomes. METHODS: A retrospective review of cases undergoing the cloverleaf ILM flap technique was conducted at a single center. This technique involves creating multiple ILM flaps in a cloverleaf configuration to enhance the stability and coverage of the macular hole. Clinical characteristics, surgical details, and outcomes were analyzed. Visual acuity measurements were converted to logMAR values. RESULTS: The study included 29 eyes of 29 patients with a mean age of 65.3 years, and 58.6% females. Macular hole aperture and base sizes were 423.7 (±264.9) µ m and 1017.5 (±229.0) µ m, respectively. Preoperatively, 62.1% of cases were phakic and 37.9% were pseudophakic. The median duration of symptoms was 90 (interquartile range: 60-300) days, with surgery performed approximately 34 (interquartile range: 28-69) days after presentation. Anatomical closure was achieved in 93.1% of cases. Patients had a mean 4.5 (±4.4) Snellen lines of improvement in their visual acuity. The median duration of follow-up was 118 (interquartile range: 36-1,491) days. CONCLUSION: The cloverleaf ILM flap technique may serve as a promising approach for challenging macular holes. By creating a cloverleaf configuration of quadratic ILM flaps folded over the macular hole, this technique enhances flap stability, potentially improving macular hole closure success.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it