• Users Online: 3261
  • Print this page
  • Email this page
 
REVIEW ARTICLE
Ahead of Print

Current management strategies for atypical macular holes


1 Associated Retinal Consultants, P.C., Royal Oak, MI, USA
2 Associated Retinal Consultants, P.C., Royal Oak; Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA

Correspondence Address:
Tamer H Mahmoud,
Associated Retinal Consultants, PC 3555 W Thirteen Mile Road Neuroscience Bldg, LL-20 Royal Oak, MI 48073
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_26_20

This review evaluates the current surgical management options for refractory and atypical macular holes (MH) and proposes a treatment paradigm for approaching complex cases. A review of literature was performed to deliver a thorough discussion of the epidemiology and pathophysiology of MH as well as the historic evolution of surgical management strategies. With this context established, an update on recent surgical advances for management of large, chronic, and highly myopic MH is provided. New small MH may be adequately treated with pars plana vitrectomy, while those ≥300 μm should undergo internal limiting membrane (ILM) peel. For MH ≥400 μm with risk factors for failure, primary intervention should involve creation of an ILM flap and various methods of flap creation are discussed. For very large MH ≥700 μm or in refractory cases, autologous retinal transplants and other recently proposed procedures should be considered. While typical MHs enjoy high initial surgical success rates, atypical and refractory MH require additional intraoperative and postoperative considerations to maximize surgical success and optimize vision. With many techniques at the surgeon's disposal, patient selection becomes critical to improving outcomes.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Marlow ED
    -  Mahmoud TH
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed258    
    PDF Downloaded8    

Recommend this journal