Dr. Shalabh Sinha, S07549, Dr. Raj Vardhan Azad
A 70 year old female patient presented with diminished vision in her left eye. She had been diagnosed with a full thickness idiopathic macular hole 3 years ago. She underwent 23 gauge vitreous surgery after an informed consent. Due to the large diameter of the macular hole exceeding 1100 microns and its chronic nature, an inverted ILM flap technique was contemplated. While the ILM was being peeled upto the edge of the macular hole, at the end it came off completely.
The ILM was removed from the eye and placed in a bowl of BSS. ILM peel was extended. Next a near total fluid air exchange was done and the ILM was placed near the macular hole. Fluid was passively aspirated and the free floating ILM danced around till it was brought over the macular hole.
This maneuver was akin to playing with a circular maze with a metallic ball. The follow up period demonstrated closure of the macular hole with 2 lines improvement in Snellen’s visual acuity. Thus a successful ILM transplantation was done.