Macular Hole Surgery Without Postoperative Head Positioning: A Technique of Viscoelastic Device Injection Covering the Temporal Internal Limiting Membrane Flap.

Abstract

The purpose of this study was to describe a technique in which a dispersive viscoelastic device is injected under air onto and around the inverted temporal internal limiting membrane (ILM) flap to close the macular hole (MH) without the need for any postoperative head positioning. A temporal ILM flap was created in the patients. The created ILM flap was inverted over the MH using perfluorocarbon (PCFL) injection. Then, after a fluid-air exchange, careful PFCL-air exchange was performed. Under air, two to three disc diameters of viscoelastic device were injected over and around the inverted flap. No postoperative head position was recommended to any patient. In all 16 eyes treated with this approach, the MH was closed with a single procedure, and there were no intraoperative or postoperative complications. Injection of a viscoelastic device over the inverted ILM flap in MH surgery is an innovative approach that does not require any special postoperative head positioning. [Ophthalmic Surg Lasers Imaging Retina 2025;56:120-122.].