Dr.RAMYA APPANRAJ, Dr.Saravanan V R
AIM: To describe various surgical techniques for management of recurrent macular hole that fail to close after primary ILM peeling surgery. METHODS: For persistent macular hole, techniques that are described are 1.Complete fluid air exchange with higher percentage of perfluoro propane or sulfurhexafluoride gas. 2.Drainage of macular hole 3.Application of drop of autologous blood, thrombin,serum 4.Free flap technique 5.Hinged flap ( Inverted flap technique) 6.Relaxing retinotomy as described by steve Charles 7. Plugging the hole with anterior or posterior capsule 8.Use of heavy silicone oil.9.Also described was inducing serous macular detachment parafoveally followed by massage of the parafoveal tissue converting the round hole into transverse slit followed by one point mechanical closure of the temporal edge of the hole. To conclude, persistant macular hole is surgically quiet challenging one, these techniques can be tried to increase further anatomical and functional success.
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