Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach
Jessica Cao, Peter K. Kaiser
Abstract
Primary surgery for macular hole (MH) closure has a high success rate with current methods of pars plana vitrectomy and internal limiting membrane (ILM) peeling. When primary surgery fails, there are several options available for secondary repair, including extension of the ILM peel, creation of an ILM flap, pedunculated ILM flap, lens capsule flap transplantation, autologous retinal transplantation, use of a human amniotic membrane plug, adjuvant autologous platelet concentrate, induction of macular detachments with subretinal blebs, and creation of retinal incisions. In this review, we discuss the practical approach to each of these surgical techniques for the management of recurrent or persistent MHs.
Topics & Concepts
VitrectomyMedicinePars planaMacular holeSurgeryInternal limiting membraneTransplantationRetinalOphthalmologyVisual acuityRetinal and Macular SurgeryIntraocular Surgery and LensesVascular Malformations Diagnosis and Treatment