Vitrectomy With Internal Limiting Membrane Transplants in the Closure of 2 Adjacent Macular Holes

Two adjacent macular holes (MHs), which were noted in the highly myopic left eye of an 85-year-old woman, is an uncommon clinical presentation. This case report presents the successful closure of the 2 adjacent MHs using internal limiting membrane (ILM) transplants during vitrectomy that included.

ILM transplants were placed within both MHs during vitrectomy that included ILM peeling and fluid gas exchange with 18% perfluoropropane (C₃F₈) and postoperative facedown positioning for 1 week.

Both MHs were successfully closed following surgery with improvement in vision and decrease in metamorphopsia.

This case suggested that relief of traction by ILM peeling and placement of ILM transplants within both MHs to provide a scaffold and stimulate glial tissue proliferation may have facilitated closure of the 2 adjacent MHs, which is a difficult management problem to manage and not previously reported to the best of our knowledge.