Perfluoro-n-octane-assisted autologous internal limiting membrane plug for refractory macular hole surgery

Purpose: To evaluate a surgical technique using a perfluoro-n-octane (PFO)-assisted autologous internal limiting membrane (ILM) plug for refractory macular holes (MHs). Methods: This study was a retrospective, consecutive, interventional case series. Patients with refractory MHs following PFO-assisted autologous ILM plugs were reviewed between October 1, 2017, and February 28, 2018. The anatomical results of MH preoperatively and postoperatively were evaluated by fundus examination and optical coherence tomography (OCT). The best-corrected visual acuities (BCVAs) before and after surgery were compared as the functional outcome. Results: Six eyes of six consecutive patients with refractory MH were enrolled in this study. Successful MH closure and BCVA improvement after the surgeries were obtained in all eyes. There were four male and two female patients, and the mean age was 63.7 ± 11.1 years. Intraoperatively, the average number of autologous ILM grafts we harvested was 2.2 ± 0.4. The mean follow-up was 6.0 ± 1.7 months. The averaged BCVA before and after the surgery at the last visit improved from 20/356 to 20/153. The ILM graft tissue was still visible, as shown by OCT, in all 6 of 6 (100%) eyes during the follow-up period. Conclusions: This surgical technique using PFO-assisted autologous ILM plug may provide an option for the treatment of refractory MH.