New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot

Abstract Background Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT). Methods This is a pro...

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Main Authors: Thais Marino de Azeredo Bastos, Laís Lauria Neves, Letícia Pinheiro de Freitas, David Leonardo Cruvinel Isaac, Antônio Marcelo Barbante Casella, Marcos Pereira Ávila
Format: Article
Language:English
Published: BMC 2025-05-01
Series:International Journal of Retina and Vitreous
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Online Access:https://doi.org/10.1186/s40942-025-00681-6
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author Thais Marino de Azeredo Bastos
Laís Lauria Neves
Letícia Pinheiro de Freitas
David Leonardo Cruvinel Isaac
Antônio Marcelo Barbante Casella
Marcos Pereira Ávila
author_facet Thais Marino de Azeredo Bastos
Laís Lauria Neves
Letícia Pinheiro de Freitas
David Leonardo Cruvinel Isaac
Antônio Marcelo Barbante Casella
Marcos Pereira Ávila
author_sort Thais Marino de Azeredo Bastos
collection DOAJ
description Abstract Background Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT). Methods This is a prospective interventional non-comparative study with three cases of recurrent or refractory macular hole treated with a new surgical technique using autologous blood clot obtained from the retinal vessels. Results This study included 3 eyes of 3 patients. All patients were previously treated with a PPV and internal limiting membrane peeling. One week post-operatively, all operated eyes showed closure of the macular hole. No complications secondary to the surgical technique occurred. Conclusion This is a small case series that obtained anatomical success in the macular hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.
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issn 2056-9920
language English
publishDate 2025-05-01
publisher BMC
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series International Journal of Retina and Vitreous
spelling doaj-art-2ae39a6912364edbb6e6935d4042aaae2025-08-20T03:16:34ZengBMCInternational Journal of Retina and Vitreous2056-99202025-05-0111111210.1186/s40942-025-00681-6New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clotThais Marino de Azeredo Bastos0Laís Lauria Neves1Letícia Pinheiro de Freitas2David Leonardo Cruvinel Isaac3Antônio Marcelo Barbante Casella4Marcos Pereira Ávila5Ophthalmology Reference Center at the Federal University of Goiás (CEROF-UFG)Ophthalmology Reference Center at the Federal University of Goiás (CEROF-UFG)Ophthalmology Reference Center at the Federal University of Goiás (CEROF-UFG)Ophthalmology Reference Center at the Federal University of Goiás (CEROF-UFG)Departament of Ophthalmology, Estadual de Londrina, UELOphthalmology Reference Center at the Federal University of Goiás (CEROF-UFG)Abstract Background Present a new surgical technique which involves using pars plana vitrectomy (PPV) combined with a free internal limiting membrane (ILM) flap anchored by an intraoperatively obtained blood clot, assisted by intraoperative optical coherence tomography (i-OCT). Methods This is a prospective interventional non-comparative study with three cases of recurrent or refractory macular hole treated with a new surgical technique using autologous blood clot obtained from the retinal vessels. Results This study included 3 eyes of 3 patients. All patients were previously treated with a PPV and internal limiting membrane peeling. One week post-operatively, all operated eyes showed closure of the macular hole. No complications secondary to the surgical technique occurred. Conclusion This is a small case series that obtained anatomical success in the macular hole closure with a reproducible technique involving the use of i-OCT to position a free ILM flap, anchored by a blood clot obtained from per operatory retinal bleeding. Further controlled research needs to be done to prove the efficacy.https://doi.org/10.1186/s40942-025-00681-6i-OCTRefractory macular holeVitrectomyILM peelingBlood clot
spellingShingle Thais Marino de Azeredo Bastos
Laís Lauria Neves
Letícia Pinheiro de Freitas
David Leonardo Cruvinel Isaac
Antônio Marcelo Barbante Casella
Marcos Pereira Ávila
New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
International Journal of Retina and Vitreous
i-OCT
Refractory macular hole
Vitrectomy
ILM peeling
Blood clot
title New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
title_full New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
title_fullStr New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
title_full_unstemmed New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
title_short New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot
title_sort new surgery technique for refractory macular hole guided by intraoperative oct free internal limiting membrane flap and autologous blood clot
topic i-OCT
Refractory macular hole
Vitrectomy
ILM peeling
Blood clot
url https://doi.org/10.1186/s40942-025-00681-6
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