Journal club on Management of refractory and recurrent macular holes: A comprehensive review
June 22, 2022
National Eye Hospital
The primary repair of full-thickness macular holes (FTMHs) through pars plana vitrectomy with internal limiting membrane peeling and gas tamponade is the current standard of practice and offers a high closure rate of approximately 90%. On the contrary, the surgical management of refractory (or persistent) and recurrent FTMHs is still a challenging and con- troversial topic in vitreoretinal surgery as multiple options have been suggested, with no consensus regarding any appropriate selection criteria or the best surgical option. This study provide a structured overview of the different surgical options currently available for the secondary repair of refractory and recurrent FTMHs. In addition to an update on epidemiology, diagnosis and description of the surgical steps they highlight the evidence available to support each of the surgical techniques, specifically focusing on the presumed mechanisms of hole closure, advantages, and known prognostic factors.