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

IF 1.9 Q2 OPHTHALMOLOGY

International Journal of Retina and Vitreous Pub Date : 2025-05-27 DOI:10.1186/s40942-025-00681-6

Thais Marino de Azeredo Bastos, Laís Lauria Neves, Letícia Pinheiro de Freitas, David Leonardo Cruvinel Isaac, Antônio Marcelo Barbante Casella, Marcos Pereira Ávila

{"title":"New surgery technique for refractory macular hole guided by intraoperative OCT: free internal limiting membrane flap and autologous blood clot.","authors":"Thais Marino de Azeredo Bastos, Laís Lauria Neves, Letícia Pinheiro de Freitas, David Leonardo Cruvinel Isaac, Antônio Marcelo Barbante Casella, Marcos Pereira Ávila","doi":"10.1186/s40942-025-00681-6","DOIUrl":null,"url":null,"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.","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":"11 1","pages":"60"},"PeriodicalIF":1.9000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107886/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Retina and Vitreous","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40942-025-00681-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

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.

查看原文本刊更多论文

术中OCT引导下治疗难治性黄斑裂孔的新技术：游离内限制膜瓣+自体血凝块。

背景：在术中光学相干断层扫描（i-OCT）的辅助下，提出了一种新的手术技术，包括使用玻璃体平坦部切除术（PPV）结合术中获得的血凝块锚定的游离内限制膜（ILM）皮瓣。方法：对3例复发性或难治性黄斑裂孔采用一种新的手术技术，利用从视网膜血管中获取的自体血凝块治疗黄斑裂孔进行前瞻性介入非比较研究。结果：本研究纳入3例患者3只眼。所有患者先前均接受过PPV和内限制膜剥离治疗。术后1周，所有手术眼黄斑孔闭合。无手术技术并发症发生。结论：这是一个小的病例系列，在黄斑孔闭合中获得了解剖学上的成功，使用了一种可重复的技术，包括使用i-OCT定位游离的ILM瓣，由术中视网膜出血产生的血凝块固定。需要进一步的对照研究来证明其有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Retina and Vitreous Medicine-Ophthalmology

CiteScore

3.50

自引率

4.30%

发文量

审稿时长

19 weeks

期刊介绍： International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities