Inner Limitant Autotransplant for a Persistant Big Macular Hole



A big and chronic macular hole is difficult to get close after a vitrectomy (ppv), but the percentage of closure decreases enormously if it has been operated before.

This is a 68 years old woman that was referred from her hospital with a big macular hole after two previous vitrectomies, last one six months ago.

We performed a 23G new ppv. As we were not sure if the previous surgeons peel or not the inner limitant membrane (ILM), we decided to stain it with G Brilliant Blue. The ILM was correctly removed and we peel new small pieces to put them into the hole as an autotrasplant. To insert the pieces into the holes is a difficult manoeuvre, considering not producing damage in the fovea. The Tano brush is a good instrument to help us. After the fluid-air interchange, SF6 gas 20% was leaved into the eye as tamponade and face down positioning was suggested. The macular hole was close.

Inner limitant membrane autotrasplant could be considered for persistent previously operated big and chronic macular holes.



Maria Carmen Desco
Valencia, Spain
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Cell Phone: +34659463908
Work Phone: +34962328100