Pilot evaluation of a new surgical technique for persistent or recurrent large macular holes

BACKGROUND AND OBJECTIVE: To describe a new surgical technique for persistent or recurrent large macular holes (MHs). PATIENTS AND METHODS: Patients with recurrent or persistent large MHs following vitrectomy with internal limiting membrane (ILM) peeling were recruited between October and September 2017 in this pilot study. All patients underwent preoperative and postoperative best-corrected visual acuity (BCVA), slit-lamp ophthalmoscopy, and spectral-domain optical coherence tomography (SD-OCT). This new technique consisted in autologous ILM patch transplantation on top of MH under perfluorocarbon liquid (PFCL) bubble, using SF6 as tamponade. The patients maintained a prone position for 3 days. RESULTS: Five eyes of five consecutive patients (two males, three females; mean age: 67.4 years) with recurrent (one patient) or persistent (four patients) MHs were successfully treated. At 1-month follow-up, mean BCVA increased from approximately 20/400 to approximately 20/63, and MHs were closed in all cases. Mean follow-up was 5 months ± 2.2 months (6 months for four out of five included eyes). Positive outcomes were consistent at last follow-up. CONCLUSION: This new technique consisting of autologous ILM patch transplantation on top of MH under PFCL bubble using SF6 as tamponade may represent a validated surgical option for persistent or recurrent large MHs.