DR. DEEPAK AGARWAL

, DR. SNEHA BATRA

Abstract

Introduction: Intravitreal injection may cause release of VMT, which can be an etiology in development of macular hole. Large macular hole often requires ILM peeling with inverted flap. However, free ILM flap may be needed in few difficult cases.

Purpose: To represent a case of macular hole formation after anti-VEGF injection and subsequent management by a free ILM flap.

Case: A 65 year old, one eyed female presented with CNVM in left eye. After 3rd anti-VEGF injection, full thickness macular hole occurred due to release of VMT. During surgery for the large FTMH, inverted ILM flap was being tried,but the flap got dislodged from hole margin. Subsequently a free ILM flap was harvested and placed in macular hole under PFCL.

Macular hole was closed on follow up.

Conclusion: Present video shows a unique case of FTMH formation after anti-VEGF. It also highlights the challenging surgery of free ILM flap for macular hole closure.