Management of Challenging Macular Holes: Current Concepts and New Surgical Techniques.
by Dilraj S. Grewal, MD, and Tamer H. Mahmoud, MD, PhD Macular hole surgery typically is associated with high anatomic success rates and satisfied patients. Unfortunately, challenging cases with poorer success rates do exist, such as holes associated with high myopia, a large diameter, or concomitant retinal detachment. For cases with suboptimal closure rates, innovative techniques have been developed to provide scaffolding that may act as a basement membrane for glial cell migration and/ or proliferation. In this paper, Dilraj S. Grewal, MD, and Tamer H. Mahmoud, MD, PhD, from Duke discuss the evolution of these procedures, as well as surgical tips and tricks in performing these newer maneuvers. The authors have also recently introduced a novel and pioneering approach with autologous retinal transplantation that is described and beautifully illustrated. Autologous retinal transplantation is a technique with potential applications for challenging macular holes, but it may also hold promise for other surgical retina problems in the future. This work is certain to be of great interest to the retina community. Howard F. Fine
Ophthalmic surgery, lasers imaging retina