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Internal limiting membrane graft for persistent macular holes after primary surgical failure

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 27/09/2013 | 11:00-12:30

Paper Time: 11:32

Venue: Hall 3 (Level 0)

First Author: L.Mendonca PORTUGAL

Co Author(s):    N. Gomes   R. Gentil   S. Guimaraes   C. Ferreira     

Abstract Details


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


Hospital de Braga, Portugal


Five eyes of 5 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 maintain face-down position for 3 days.


Macular hole characteristics were as follows: smaller hole diameter ranged between 392µm and 857µm (average of 618.75µm). Base diameter ranged between 964µm and 2847µm (average of 1755µm). Macular hole index ranged between 0.17 and 0.49 (average of 0.29). Anatomical closure was achieved in all patients. Visual acuity improved in all cases, with an average improvement of 11,2 ETDRS letters. 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.

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