As illustrated in the video, 23-gauge pars plana vitrectomy ports were placed. Cautery was applied to the nasal retina to minimize the risk of oozing/bleeding while harvesting the neurosensory retinal transplant. Endolaser was applied around the harvesting site. Vertical scissors were utilized to harvest the graft. Before completely harvesting the neurosensory retinal transplant, perfluoro-n-octane (PFO) heavy liquid was injected up to the equator level, then the neurosensory retinal transplant was teased and dragged (under the PFO using the Finesse flex loop) toward the macular hole site, where it was gently tucked in position. PFO was left in the eye for 5 days to achieve tamponade (with emphasis on sitting up or lying flat on the back positions). After 1 week, the patient underwent PFO–air exchange, followed by infusion of sulfur hexafluoride (SF₆) gas (18%) with face-down positioning for 5 days. At the 4-week follow-up visit, vision had improved from counting-fingers to 20/400, and the macular hole was closed with the neurosensory retinal transplant in position.

Financial Disclosure: Dr. Tarek Alasil discloses no financial relationships.