Lamellar Macular Hole Repair Using Inverted ILM Flap Technique

In this clinical video, Dr. Atul Dhawan uses an inverted ILM flap for managing a lamellar macular hole. He also describes a novel technique he calls colored-visco suction-assisted ILM transplantation (CV-SAIT) to restructure the foveal contour by stimulating Müller cell proliferation. At presentation, the patient had posterior vitreous detachment (PVD) and separation at the outer plexiform layer.

After PVD induction and posterior hyaloid and ERM peeling, Dr. Dhawan stained the ILM and began peeling with plans to save a small piece for the inverted flap. However, when the piece detached, he decided to perform transplantation instead by CV-SAIT. He used color visco to place the piece over the hole, and when it became displaced, used active suction from the remaining visco to set it back in place. Air was replaced by SF6 gas in the end.

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