Temporal inverted internal limiting membrane flap technique for a 500 μm full-thickness macular hole: A case report.
Sebastian Sirek, Justyna Sierocka-Stępień, Mikołaj Guzikowski et al.
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Case in brief
A 70-year-old woman presented with reduced vision in her left eye. Optical coherence tomography showed an hourglass-shaped full-thickness macular hole measuring 500 μm at its minimum aperture, with retinal cystic changes and thickened, rounded edges; examination and OCT also identified a smaller full-thickness hole in the right eye. She underwent 25-gauge pars plana vitrectomy using a temporal inverted internal limiting membrane flap, with fluid-air exchange and 25% sulfur hexafluoride gas. OCT at 33 and 45 days showed complete closure. At final follow-up, visual acuity had improved in both eyes.
What made this case unusual
The left-eye hole had an hourglass configuration with cystic retinal changes and rounded, thickened edges, alongside a smaller full-thickness macular hole in the fellow eye.
Diagnostic / clinical pearl
OCT can characterize macular-hole aperture and morphology and identify a fellow-eye hole; in this case, it also documented closure after temporal inverted ILM flap surgery.