Current Trends in Macular Hole Repair

Abstract

Purpose To describe and detail the current surgical trends in the repair of macular holes so that retinal surgeons may have access to the most up to date advances in macular hole repair technology. Recent findings The inverted ILM flap and various iterations of the technique have been the dominant surgical trends for repair of both routine macular holes and those with a higher risk of non-closure when using standard surgical techniques. Additional surgical techniques include use of other acellular scaffolds such as lens capsule flaps or human amniotic membrane, autologous retinal transplantation, application of autologous blood products, and macular detachment with retinal incisions. Summary Surgical innovation in the last decade has focused on techniques to address core concepts of pathology that lead to macular hole formation or retard its repair, namely: novel ways to promote organized cell proliferation, release tractional forces on the retina, and increase retinal ''compliance'' to cover the foveal defect.