Epiretinal Amniotic Membrane Patch as a Temporary Scaffold for Refractory Macular Hole Closure: A Case Report

Macular holes are central retinal defects that can severely impair vision. While standard surgical management including pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling is highly effective for most macular holes, lower success rates are observed with chronic or large holes. Several advanced surgical maneuvers have recently emerged, including inverted ILM flaps, autologous retinal transplant, subretinal blebs, and subretinal amniotic membrane (AM) grafts. While subretinal AM grafts demonstrate improved closure rates, amniotic tissue can block reformation of subfoveal outer retinal structures. The use of larger AM patches (> 6 mm diameter) to facilitate hole closure through the creation of a temporary pre-retinal scaffold is a novel surgical approach for refractory macular holes. We describe a large chronic stage-4 macular hole refractory to standard treatment, successfully treated with epiretinal AM transplantation and patch removal 2 months later. We highlight the feasibility of AM removal and importance of further refining this technique. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2025;56:442-445.]</b>.