Endotamponade-Free Macular Hole Surgery

This video demonstrates a technique for closing a macular hole without filling the vitreous cavity with gas. This approach offers several advantages over gas endotamponade, including allowing for immediate OCT examinations after surgery and eliminating stringent postoperative positioning requirements and certain travel restrictions for patients. First, a posterior vitrectomy is performed, followed by injection of trypan blue dye and perfluorocarbon liquid. Then, a half moon–shaped ILM flap is created, reflected over the macular hole, and stabilized with adhesive viscoelastic before the perfluorocarbon liquid is removed. The authors report that many patients experience some immediate improvement in visual acuity even one day postoperatively. In this case, the patient's vision improved significantly, with complete closure of the macular hole after 6 months.

Additional authors: Drs. Anna Urbanska, Piotr Rakowicz, and Maksym Ciesielski.