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Topical Drop Therapy for Failing Macular Holes after Internal Limiting Flap Surgery
Mohammad Z Siddiqui1, Gaurav K Shah2, Kevin J Blinder1
1The Retina Institute, St. Louis, Missouri, USA.
Retinal Cases & Brief Reports
|February 27, 2026
Summary
Topical drops effectively closed macular holes (MHs) that failed to heal after internal limiting membrane (ILM) flap surgery. This treatment offers a potential solution for persistent macular holes.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Vitrectomy with internal limiting membrane (ILM) flap is a standard procedure for macular hole (MH) repair.
- Topical treatments for MHs have shown limited success, especially in cases of surgical failure.
Purpose of the Study:
- To evaluate the efficacy of a topical drop regimen for closing macular holes (MHs) that remained open after ILM flap surgery.
Main Methods:
- A retrospective review of 3 eyes with open MHs post-ILM flap surgery.
- Data collected included preoperative visual acuity, MH size, surgical tamponade, time to closure, and final visual acuity.
Main Results:
- The average MH size was 743.3µm.
- All 3 eyes had open MHs postoperatively.
- A regimen of topical steroids, NSAIDs, and carbonic anhydrase inhibitors administered twice daily for a mean of 33 days resulted in successful MH closure in all cases.
Conclusions:
- Topical therapy demonstrates potential as an adjunctive treatment for achieving macular hole closure after ILM flap surgery failure.
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