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Prabhu Shanker
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Drs. Prabhu Shanker and P. Janakiraman discuss closure technique for large macular holes. In an example case, a patient presented with a large macular hole of 813 microns. Regular ILM peeling technique will lead to a type 2 closure so an inverse ILM flap technique was performed. Postoperative prone positioning was advised for 4 days. On the tenth postoperative day a type 1 closure was seen on OCT.
Posted: 8/07/2017
Prabhu Shanker
Drs. Prabhu Shanker and P. Janakiraman discuss closure technique for large macular holes. In an example case, a patient presented with a large macular hole of 813 microns. Regular ILM peeling technique will lead to a type 2 closure so an inverse ILM flap technique was performed. Postoperative prone positioning was advised for 4 days. On the tenth postoperative day a type 1 closure was seen on OCT.
Posted: 8/07/2017
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Patel Gordon-Bennett
8 years ago
Not happy with what is called type 1 closure here. This is pretty much folds of ILM stuffed into the hole. The hole has not closed! A wider ILM peel might have also helped to close the hole. It would be interesting to know what vision thisnoatient wnded up with.
SHALABH SINHA
8 years ago
Too many pinches around the macula will cause more damage around the macular hole. Sparing the papillo-macular bundle will result in reducing iatrogenic damage. A inverted temporal flap works without having to stuff the ILM into the hole. Stuffing itself will damage photoreceptors around the hole. Using a soft tip at the end risks the chance of having a free flap.