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Temporal Arcuate Relaxing Retinotomy for Persistent Full-Thickness Macular Holes: Anatomical and Functional
Luca Ventre1, Erik Mus1,2, Antonio Valastro1
1Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d'Aosta, Via L. Vaccari 5, 11100 Aosta, Italy.
Journal of Clinical Medicine
|January 28, 2026
Summary
Temporal arcuate relaxing retinotomy achieved a 78% closure rate for persistent full-thickness macular holes (FTMHs) after failed repairs. This procedure also led to significant visual acuity improvement in most patients.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Hole Repair
Background:
- Limited evidence exists for secondary repair of persistent full-thickness macular holes (FTMHs).
- Temporal arcuate relaxing retinotomy is a salvage technique with scarce functional safety data.
- This study evaluates real-world outcomes of this retinotomy for FTMHs post-failed standard repair.
Purpose of the Study:
- To assess the efficacy and safety of temporal arcuate relaxing retinotomy for persistent FTMHs.
- To evaluate OCT-confirmed closure rates and best-corrected visual acuity (BCVA) changes.
- To analyze retinotomy site morphology and functional outcomes, including visual field defects.
Main Methods:
- Retrospective case series of 9 eyes with persistent FTMH after ≥1 failed pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling.
- Repeat PPV with temporal arcuate relaxing retinotomy was performed.
- Outcomes included OCT-confirmed closure, BCVA, ellipsoid zone (EZ) status, retinotomy morphology, and visual field testing.
Main Results:
- OCT-confirmed closure was achieved in 77.8% of eyes (7/9) after gas absorption.
- BCVA improved in 88.9% of eyes (8/9), with a mean improvement of -0.64 logMAR.
- One patient reported a new, well-tolerated paracentral nasal scotoma; visual fields were obtained in 6/9 eyes.
Conclusions:
- Temporal arcuate relaxing retinotomy demonstrated a 78% closure rate and improved BCVA in persistent FTMHs.
- Limited symptomatic scotoma was reported in assessed patients.
- Larger studies with standardized functional endpoints are needed to define patient selection and compare with other salvage options.
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