Dancing ILM——SS-iOCT-Guided Macular Hole Surgery

A 40-year-old female presented a refractory full-thickness macular hole (approximately 1 PD) in her right eye after primary vitrectomy accompanied by intraretinal cystoid edema and slight temporal retinal detachment (fig. 1). Pars plana vitrectomy (PPV) with extended ILM peeling and ILM flap tamponade was performed under the guidance of SS-iOCT using digital navigation surgical microscope (FOcean, TowardPi).

The peeling ILM was clearly visualized in real time on high-resolution intraoperative OCT (gif. 1). Under the guidance of iOCT, ILM flap was created and tamponaded it into the macular hole precisely (gif. 2). Clear imaging persisted even after fluid-air exchange, ensuring optimal flap positioning (gif. 3). At postoperative day 10, complete anatomical closure of the macular hole was confirmed on OCT image (fig. 2).

Case courtesy: Prof. Genjie Ke from the First Affiliated Hospital of University of Science and Technology of China.

*TowardPi microscope is not cleared by CE/MDR or FDA yet.