COMPLEX MACULAR HOLE CLOSURE BY TEMPORAL INTERNAL LIMITING MEMBRANE FLAP WITHOUT ENDOTAMPONADE.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Retinal Surgery

Background:

• Complex macular holes (MH) present significant surgical challenges.
• Current treatments often rely on endotamponade agents.
• A novel technique avoiding endotamponade may offer advantages.

Purpose of the Study:

• To assess the safety and efficacy of a new surgical technique for complex macular hole (MH) repair.
• To evaluate the imaging features associated with this novel approach.
• To determine the outcomes of a no-endotamponade strategy in MH surgery.

Main Methods:

• Retrospective review of consecutive cases undergoing pars plana vitrectomy.
• Utilized internal limiting membrane (ILM) flap stabilized with perfluorocarbon liquid and viscoelastics.
• Complex MH defined by basal linear diameter (≥400 µm) and/or high myopia; no endotamponade used post-surgery.

Main Results:

• 100% MH closure achieved in 24 eyes; 33% had type 1A closure.
• Mean logarithm of the minimum angle of resolution visual acuity improved significantly postoperatively.
• 12.5% developed foveal gliosis; 41.7% developed nasal epiretinal membrane; one case of vitreous hemorrhage.

Conclusions:

• The novel no-endotamponade technique is effective for complex macular hole closure.
• The development of epiretinal membrane warrants further investigation into its clinical significance.
• This approach offers a viable alternative for complex MH repair.