Dr.kavitha duraipandi, K13517
Though success of macular hole surgery is high , it is not 100%. The reason for a failure to close in a case of macular hole surgery is multifactorial . preoperative factors like diameter, form of the hole, status of the RPE) is to be taken into account.
Persistence of surface traction, inadequacy of the postoperative tamponade, pocket of residual vitreous gel pooled inside the hole, incomplete fluid-air exchange could be other contributing factors.
Many surgical techniques like Repeat vitrectomy ILM free-flap, ILM Graft, Autologous retinal transplant, Arcuate retinotomy and radial incisions have been reported.
Here we describe a macular hole re operation , wherein a ILM patch graft was placed over the hole and tucked in using a Diamond dusted membrane scrapper. The macular hole closes at 2 weeks post op with 30 % gas fill in situ.
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