International journal of retina and vitreous · 2025
New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot.
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de Azeredo Bastos Thais Marino, Neves Laís Lauria, de Freitas Letícia Pinheiro, Isaac David Leonardo Cruvinel, Casella Antônio Marcelo Barbante, Ávila Marcos Pereira
Аннотация
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 complications secondary to the surgical technique occurred.
CONCLUSION: This is a small case series that obtained anatomical success in the macular hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.
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 complications secondary to the surgical technique occurred.
CONCLUSION: This is a small case series that obtained anatomical success in the macular hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.