PMC6938193_01
Case 1. (A) Preoperative OCT shows a large full-thickness macular hole. (B) 1 month postoperatively, the inverted flap is visualized as a hyperreflective tissue nasal to the fovea. (C) OCT 3 months after surgery shows some degree of atrophic change in the inner retinal surface limited to the temporal side of fovea.
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The minimum size of the MH was 553 microm, and the basal diameter was 1100 microm (Figure 4A). An area of hyperreflective tissue on the inner retinal surface and nasal to fovea was seen on OCT, which corresponded to the location of the inverted ILM flap (Figure 4B). Besides outer retinal regeneration, some degree of inner retinal dimpling at the temporal side was observed at 3 months after surgery (Figure 4C).
PMC6938193_02
Case 2. (A) Preoperative OCT shows a large full-thickness macular hole. (B) 1 month postoperatively, closed macular hole is shown with two hyperreflective spaces created by an inverted flap. (C) These spaces were filled with regenerative tissue 3 months after surgery. (D) 6 months postoperatively, OCT shows regenerated outer retina with a small defect in the ellipsoid zone. Atrophic changes in the inner retinal surface are most prominently seen at the temporal side of the fovea.
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A 65-year-old man presented with a large full-thickness MH with a minimal diameter of 744 microm and basal diameter of 1337 microm (Figure 5A). OCT showed closed MH with two hyporeflective spaces, created by the inverted flap (Figure 5B). At 3 months after surgery, these spaces were filled with regenerated tissue with improved foveal contour (Figure 5C). Although the peeling was circular and involved both the temporal and nasal sides of fovea, inner retinal dimpling was most prominent at the temporal side (Figure 5D).