PT  - JOURNAL ARTICLE
AU  - Joana Pires
AU  - Jeroni Nadal
AU  - Nuno Lourenço Gomes
TI  - Internal limiting membrane translocation for refractory macular holes
AID  - 10.1136/bjophthalmol-2015-308299
DP  - 2017 Mar 01
TA  - British Journal of Ophthalmology
PG  - 377--382
VI  - 101
IP  - 3
4099  - http://bjo.bmj.com/content/101/3/377.short
4100  - http://bjo.bmj.com/content/101/3/377.full
SO  - Br J Ophthalmol2017 Mar 01; 101
AB  - Background/aims Closure is more difficult to achieve in macular holes that remain open following a previous unsuccessful pars plana vitrectomy (PPV). We present our results with the internal limiting membrane (ILM) translocation technique that is used to optimise outcomes in refractory macular holes.Methods A prospective, interventional, case series was conducted. 12 eyes of 12 consecutive patients with incomplete sealing of the macular hole (open and type 2 closure) after a previous PPV with ILM peeling were included. Measured baseline parameters included best-corrected visual acuity (BCVA) and macular hole smallest diameter, base diameter and height. Surgeries were performed by harvesting a fragment of the ILM near the vascular arcades and subsequently placing it inside the hole. Postoperative measured outcomes included macular hole status, foveal contour, outer retina integrity, BCVA and surgery-related complications.Results Anatomic closure occurred in 11 of 12 eyes (91%). This technique elicited a statistically significant improvement in BCVA (p=0.008). Mean BCVA was 20/400 at study baseline and 20/160 at final follow-up. However, less than 16.7% of cases had a final BCVA of ≥20/63.Conclusion The ILM translocation technique seems to facilitate persistent idiopathic macular hole closure, where primary surgery with PPV and ILM peeling failed.