Intraoperative Optical Coherence Tomographic Imaging During Internal Limiting Membrane Retracting

A 44-year-old man noticed a reduction in his vision that our examination showed was due to a myopic macular hole. The internal limiting membrane (ILM) retracting-door technique was used to successfully close the macular hole. A large flap of the ILM was created on the nasal side of the macular hole with the ILM forceps, and it was carried temporally over the macular hole. Unfortunately, the ILM flap shrank and wadded due to contraction of an epiretinal membrane (ERM). Viscoelastic material was injected onto the ILM flap to stabilize it and draped back to cover the macular hole, which was confirmed by intraoperative optical coherence tomography (iOCT). The macular hole was observed to be closed postoperatively, and it was covered with an ERM that gave it a cellophane-like macular reflex. We conclude that iOCT can be helpful in performing the ILM retracting-door technique in complicated cases to control the position of the temporally hinged ILM flap covering a macular hole and also to monitor its position