AIR TAMPONADE WITH 24 HRS FACE DOWN POSITION IN INVERTED ILM FLAP FOR LARGE MACULAR HOLES CASE SERIES

Abstract

Macular holes (MH) formation is given by the centrifugal tangential traction of an anomalous posterior vitreous detachment. They mostly occur in the sixth to seventh decade of life with female preponderance1, in general population varies from 0.2 to 3.3 per 1,000. Large macular holes have been described as those larger than 400 μm located in the fovea involving all retinal layers. They account up to 44% of risk surgical failure with conventional removal or peeling of the internal limiting membrane (ILM).3 Michalewska et al. have proposed a new strategy to increase the surgical success in large MH cases, using an inverted flap technique to aim the flattening and reposition of the MH edges which increases the rate up to 98% of surgical success in large MH. There´s also been described for large MH approach the use of autologous retinal transplantation, transforming bovine growth factor B2, autologous platelet concentrate or human amniotic membrane. The aim of this case series is to report for the first time in the literature the success on a single surgery closure rate visual and structural changes in ILM flap technique with air tamponade and 24hrs face down position for large MH.