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Background <p>Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT).</p> Methods <p>This is a prospective interventional non-comparative study with three cases of recurrent or refractory macular hole treated with a new surgical technique using autologous blood clot obtained from the retinal vessels.</p> Results <p>This study included 3 eyes of 3 patients. All patients were previously treated with a PPV and internal limiting membrane peeling. One week post-operatively, all operated eyes showed closure of the macular hole. No complications secondary to the surgical technique occurred.</p> Conclusion <p>This is a small case series that obtained anatomical success in the macular&#xa0;hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.</p>

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New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot

  • 期刊论文

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  • 发表日期：

    2025年5月27日

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  • Thais Marino de Azeredo Bastos,
  • Laís Lauria Neves,
  • Letícia Pinheiro de Freitas,
  • David Leonardo Cruvinel Isaac,
  • Antônio Marcelo Barbante Casella,
  • Marcos Pereira Ávila

摘要

Background

Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT).

Methods

This is a prospective interventional non-comparative study with three cases of recurrent or refractory macular hole treated with a new surgical technique using autologous blood clot obtained from the retinal vessels.

Results

This study included 3 eyes of 3 patients. All patients were previously treated with a PPV and internal limiting membrane peeling. One week post-operatively, all operated eyes showed closure of the macular hole. No complications secondary to the surgical technique occurred.

Conclusion

This is a small case series that obtained anatomical success in the macular hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.