To describe a new surgical technique for macular hole closure using a patch of internal limiting membrane for persisting macular holes who have underwent pars plana vitrectomy with internal limiting membrane peeling.


Six eyes of 6 patients presented to our hospital with persistent macular holes after having underwent pars plana vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. All patients underwent a second vitrectomy, with removal of a fragment of ILM from the region adjacent to the vascular arcades and placement of this fragment on the bed of the macular hole. Fluid air exchange was performed and intra-ocular tamponade with C3F8 was used. Patients were instructed to avoid prone position for 3 days.


Anatomical closure was achieved in all patients. Visual acuity improved in all cases, with an average improvement of 11,2 ETDRS letters at the 6 month visit.No major complications were observed. ILM graft could be a potential alternative for the treatment of macular holes who fail the first surgery, when ILM peeling has already been performed. A higher number of patients is needed to further evaluate this new technique.