Temporal Arcuate Relaxing Retinotomy for Persistent Full-Thickness Macular Holes: Anatomical and Functional Outcomes

BACKGROUND: to evaluate the anatomical and functional outcomes associated with temporal arcuate relaxing retinotomy technique for persistent full-thickness macular hole (FTMH) repair. METHODS: a retrospective, single-center, interventional study of temporal relaxing retinotomy in eyes with persistent FTMHs following one or more standard repair procedures with pars plana vitrectomy and internal limiting membrane peeling. Patients received an additional pars plana vitrectomy and temporal arcuate relaxing retinotomy, followed by fluid-air and air-gas exchange. Key postoperative outcomes included the achievement of FTMH closure and changes in visual acuity from baseline. RESULTS: nine patients with persistent FTMHs were included, with a median age of 70 years (range, 58-76 years). The diameter of the 9 FTMHs ranged from 412 to 1037 µm (median, 613 µm). Vitrectomy and temporal relaxing retinotomy were performed in all 9 eyes. Successful FTMH closure was achieved in 7 of 9 eyes (closure rate, 78%), with an average postoperative follow up of 10.4 months (range: 2 to 20 months). 8 of 9 eyes (89%) achieved BCVA improvement during postoperative follow-up, including the long-standing FTMHs. Overall, mean BCVA (± SD) improved significantly from 1.26 ± 0.51 logMAR at baseline to 0.56 ± 0.27 logMAR during postoperative follow-up (P = 0,002). CONCLUSIONS: Temporal arcuate relaxing retinotomy may be an effective method to promote anatomical closure and to improve vision outcomes in patients with persistent FTMHs.