In this episode, a senior vitreoretinal fellow peels both the ERM and ILM to surgically treat a chronic full-thickness macular hole. The fellow demonstrates a number of fundamental techniques for macular hole surgery including the use of Tissue Blue to stain the ILM (and negatively stain the ERM), the “pinch and peel” technique to peel ERM and fracture the ILM, and the use of a superior ILM flap to close the hole. There are certainly many ways to surgically manage this patient and we would be interested to hear from the RetinaRounds community how you would manage this case!
