Contralateral Autologous Internal Limiting Membrane Transplantation for Closure of a Refractory Macular Hole: Surgical Technique

BACKGROUND AND OBJECTIVE: To determine the efficacy of a new surgical technique involving use of a contralateral autologous internal limiting membrane (ILM) free flap for closure of a refractory macular hole (MH). PATIENTS AND METHODS: Closure could not be achieved after several MH surgeries in a 72-year-old woman with an epiretinal membrane (ERM) in the right eye and a chronic MH in the left eye. Therefore, the authors performed surgery on the left eye using a contralateral autologous ILM free flap obtained during ERM surgery performed on the right eye. RESULTS: The refractory MH had disappeared, and the patient's corrected visual acuity was improved in both eyes by 4 months after surgery. CONCLUSION: When a suitable free flap cannot be obtained from the operated eye, contralateral autologous ILM transplantation has the potential to improve functional and anatomical outcome's in an eye with a refractory MH.