Outcomes of descemet membrane epiretinal graft for refractory macular hole closure

Purpose: To report the visual and anatomical outcomes of Descemet membrane epiretinal graft for refractory full-thickness macular holes (MHs). Methods: This interventional case series included patients with refractory MH who previously underwent standard pars plana vitrectomy with internal limiting membrane peeling for repair of MH with no success. Donor corneas unsuitable for keratoplasty were stripped at the Eye Bank. The corneoscleral button was stained with blue dye, punched to obtain a 2-mm Descemet membrane graft, which was positioned over the MH. At the end of surgery, 20% sulfur hexafluoride gas tamponade was administered. Results: Twelve eyes of 12 patients with a mean follow-up of 8 6 4 months were included. The MH closure rate was 91.7%. Best-corrected visual acuity significantly improved from 1.09 6 0.56 preoperatively to 0.46 6 0.54 logMAR (20/63 Snellen) after surgery (P = 0.006). The external limiting membrane and ellipsoid zone recovery rates were 33.3% and 41.7%, respectively. Conclusion: Descemet membrane epiretinal graft leads to satisfactory anatomic and visual outcomes for eyes with refractory MH.