Dr. RAMANUJ SAMANTA

, Dr. SREERAM J, DR. AJAI AGRAWAL, Prof.SANJEEV KUMAR MITTAL

Abstract

Traumatic full-thickness macular hole (TMH) is one of the protean manifestations of blunt trauma and is associated with significant visual loss. As a proportion of TMH closes spontaneously, initial observation is advocated for a short duration of 2-3 months. Persistent TMH requires parsplana vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade as definitive management. Large TMH may require additional special manoeuvres like inverted ILM peeling or retinal autograft for complete closure. However, single technique may not fit all TMH and it needs to be tailored according to size of hole, and other co-existent retinal manifestations. Herein, management of TMH in different scenarios are demonstrated ranging from isolated TMH to TMH concurrent with other retinal features. Various intricacies of ILM peeling involving large arcade to arcade peeling, 2-step macular ILM-rhexis, trimming and tucking of petaloid ILM into the hole are prime highlights of this presentation.