New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot

Abstract

Background Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT). Methods This is a prospective interventional non-comparative study with three cases of recurrent or refractory macular hole treated with a new surgical technique using autologous blood clot obtained from the retinal vessels. Results This study included 3 eyes of 3 patients. All patients were previously treated with a PPV and internal limiting membrane peeling. One week post-operatively, all operated eyes showed closure of the macular hole. No complica tions secondary to the surgical technique occurred. Conclusion This is a small case series that obtained anatomical success in the macular hole closure with a reproduc ible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per oper atory retinal bleeding. Further controlled research needs to be done to prove the efficacy.